Abstract
Case 1 involved a 37-year-old man who was seen at the hospital because of abnormalities pointed out at a medical checkup. Abdominal CT scan showed disruption of the pancreatic duct in the pancreas body, dilatation of the caudal pancreatic duct, and contraction of the pancreas tail. MRCP visualized disruption of the main pancreatic duct and dilatation of the caudal pancreatic duct. Invasive duct cell carcinoma of pancreas was diagnosed and the resection of the pancreas body and tail was performed. On the resected material, a 1.4-cm tumor with invasion into the main pancreatic duct was identified.
Case 2 involved a 48-year-old man who was referred to the hospital because of suspected acute pancreatitis. Abdominal CT scan showed an about 1.5-cm tumor at the pancreas tail and dilatation of the pancreatic duct caudal from the tumor. Endoscopic retrograde pancreatography (ERP) revealed disruption of the main pancreatic duct. The resection of the pancreas body and tail was performed with a diagnosis of invasive duct cell carcinoma of pancreas. The resected material disclosed a 1.3-cm tumor with invasion into the main pancreatic duct.
Histopathological findings in both cases included monotonous proliferation of eosinophilic cells with small nucleus, positive response to chromogranin A staining, and negative responses to various hormone stainings. From these findings, non-functioning endocrine cell tumor of pancreas was diagnosed.
In the treatment of endocrine cell tumors of pancreas, it may be appropriate to interpret the involvement of the main pancreatic duct as a malignant finding.
