十二指腸に浸潤・穿破した膵石合併粘液産生膵癌の1例

抄録

A 70-year-old male who had been under observation for chronic alcoholic pancreatitis with pancreatolith and pancreatic cyst was admitted to our hospital because of epigastralgia. CT scan showed a pancreatolith in the head of the main pancreatic duct and multiple pancreatic cysts communicating with the dilated main pancreatic duct. A fistula was found in the duodenal bulb by endoscopy. Endoscopic fistulography revealed a pancreato-duodenal fistula and the dilated pancreatic duct containing mucus. Diagnosis of mucin producing adenocarcinoma was made by biopsied specimen. Pancreatectomy was performed and the resected specimen indicated that the pancreatolith was impacted in the head of the main pancreatic duct and the pancreato-duodenal fistula was formed in the body of the pancreas. The tumorous tissues were histopathologically characterized by papillary adenocarcinoma which were mainly presented in main and large pancreatic ducts and invaded into pancreatic parenchyma, duodenum and stomach.