A case of invasive ductal carcinoma of the pancreas with a cyst lacking an ovarian-like stroma

Abstract

A 57-year old woman was admitted to our hospital complaining of body weight loss. Several imaging modalities showed a huge, round cyst with mural nodules in the tail of the pancreas and a solid tumor in the pancreatic parenchyma adjacent to the cystic lesion. Distal pancreatectomy, splenectomy, left adrenalectomy, resection of the colon, and partial resection of the left kidney were carried out.
Histologically, the cyst wall lacking an ovarian-like stroma was composed of different types of epithelium with moderate to severe atypia. The solid component of the tumor was tubular adenocarcinoma in the pancreatic parenchyma and invasive cancer was found in the cystic wall and extrapancreatic tissue. Regarding the oncogenesis of this case, the following possibilities exist: (1) invasive mucinous cystadenocarcinoma; (2) invasive carcinoma derived from an intraductal tumor; (3) invasive ductal carcinoma of the pancreas with secondary cyst.