Abstract
A 69-year-old man with the chief complaint of epigastralgia was admitted to our hopsital. Endoscopic retrograde cholangiopancreatography revealed pancreas divisum. The dorsal pancreatogram via the minor papilla showed an irregular stenosis, 2.5cm in length, in the pancreas head, and an obstruction distal to the stenosis. The ventral pancreatogram showed no malignant changes, Computed tomography revealed a mass, 4cm in diameter, in the pancreas head with invasion to the portal vein. Preoperative diagnosis was dorsal pancreatic cancer with pancreas divisum. A pancreatoduodenectomy with combined resection of the portal vein was performed. Macroscopic examination of the resected specimen disclosed a nodular mass, 3.5×3.8×4.0cm in size, which occupied the most area of the pancreas head with normal ventral pancreas at the inferior margin. Only 25 cases of pancreas cancer with pancreatic divisum have been reported in the Japananese literature including our case. The pancreatic carcinomas developed in the dorsal pancreas in 24 of 25 cases, and obstructive jaundice occurred in two of 25 cases.
