A Case of Intraductal Papillary Mucinous Adenocarcinoma of the Pancreas with Rapid Progression to Rupture

Abstract

We report a case of intraductal papillary mucinous carcinoma (IPMC), which was diagnosed as a ruptured cyst. The patient was an 82-year-old man with abdominal computed tomography (CT) showing multiple cystic lesions with substantial components in the tail of the pancreas and a small amount of ascites around the lesions. A ruptured pancreatic cyst was diagnosed and ultrasonographic endoscopic transgastric drainage was performed on the fluid components around the cysts. Ascitic fluid cytology was classified as Class II. Pancreaticoduodenectomy was performed 62 days after symptom onset. The final diagnosis was IPMC (T2, N0, M0 pStage Ib [pancreatic cancer treatment protocol, 7th edition]). The IPMC transitioned to anaplastic carcinoma. Six months after surgery, metastatic bone tumors and fractures were observed in the femur, tibia, and humerus. He underwent osteosynthesis, but his general condition gradually deteriorated and he died 1 month later.