2017 Volume 32 Issue 2 Pages 168-177
Pancreatic cancer is exceedingly difficult to detect at an early stage. We report the case of a 54-year-old woman with microinvasive pancreatic cancer that was detected while the patient was receiving hormone therapy for breast cancer. During follow-up, computed tomography (CT) scan showed a cystic lesion in the pancreatic tail, which rapidly increased in size within a year. The lesion was diagnosed as a pancreatic tumor and a distal pancreatectomy was performed. Intraoperative frozen section analysis incidentally revealed malignant cells at the first margin of the pancreas, and so an additional pancreatectomy was performed. The cystic lesion was microscopically diagnosed as an epidermoid cyst with microinvasive pancreatic cancer and pancreatic intraepithelial neoplasia at the first margin. The malignancy was not detected by preoperative imaging, including contrast CT, endoscopic ultrasound (EUS), magnetic resonance cholangiopancreatography (MRCP) or positron emission tomography-CT. However, a retrospective review indicated that a slight irregularity of the main pancreatic duct near to the lesion could be observed with EUS and MRCP. The imaging findings from our case are extremely valuable and should be shared to facilitate the detection of early stage pancreatic cancers.
