Adenosquamous carcinoma derived from intraductal papillary mucinous neoplasm of the pancreas. A case report

Abstract

A 70-year-old man presented with upper abdominal fullness. Gastroendoscopy showed a bulging tumor suspicious of a submucosal tumor. CT showed the presence of tumor, 8 cm in diameter, originating from the tale of the pancreas and invading the stomach. Balloon ERP showed irregular and dilated main pancreatic duct and defect, suggesting mucin or mural nodule in the main pancreatic duct. Endoscopic boring biopsy from the stomach confirmed the presence of carcinoma. The patient underwent total gastrectomy, distal pancreatectomy, splenectomy, partial resection of the transverse colon, and regional lymph nodes dissection. Final pathological diagnosis was adenosquamous carcinoma derived from intraductal papillary mucinous neoplasm (IPMN) and transition from IPMN to adenosquamous carcinoma was clearly observed. Since no case of adenosquamous carcinoma derived from IPMN has been reported in the English and Japanese literature, we report the case and discuss the malignant potential of IPMN.