2012 Volume 27 Issue 4 Pages 617-625
A 67-year-old male visited our hospital with a chief compliant of lower left abdominal pain, and extracorporeal ultrasonography (US) revealed the presence of a mass in the pancreatic head. Therefore, he was admitted to this department for intensive examination and treatment. US showed a mass measuring 10×10mm in size with low echo level partially coexisting with a high echo level in the pancreatic head, with no evidence of dilatation of the main pancreatic duct. In the coronal arterial phase of multidetector-row computed tomography (MDCT), a pale low-density area was observed located just beneath the pancreatic capsule, remote from the main pancreatic duct. Endoscopic retrograde cholangiopancreatography (ERCP) showed no obstruction or stenosis of the pancreatic duct. The patient was diagnosed as having stage I pancreatic cancer, and was transferred to the Department of Surgery, where he underwent pancreatoduodenectomy. The postoperative pathological diagnosis was invasive pancreatic ductal carcinoma (well-differentiated to poorly differentiated tubular adenocarcinoma) and because metastasis was found in No. 13a lymph node, the diagnosis was upstaged to stage II. This is a report of a rare case of pancreatic-field-type small pancreatic cancer not involving the main pancreatic duct.
