Abstract
Pancreatic carcinoma in situ has reportedly increased, but is still rare and mostly diagnosed incidentally. We report herein a case of pancreatic carcinoma in situ which was resected based on intraoperative cytodiagnosis. A 76-year-old man was followed for hyperlipidemia. His serum CA19-9 level was found to be elevated. Endoscopic retrograde pancreatography showed no ductal lesions, but the aspirated pancreatic juice contained adenocarcinoma cells cytologically. The tumor location in the pancreas was unclear in preoperative examinations. On February 12. 1999, a laparotomy was performed. Pancreas was separated at the left edge of superior mesenteric vein. Adenocarcinoma cells were found cytologically in the pancreatic juice from the cranial duct, and then pylorus preserved pancreatoduodenectomy was performed. No tumors were identified macroscopically. Histological findings revealed two lesions of CIS with papillary proliferative mucosa and multiple hypertrophy. A glucagonoma 2 mm in diameter was also found at the uncus. The patient is alive without recurrence 6 years and 9 months after the operation.
