Branch-duct intraductal papillary mucinous neoplasm derived carcinoma and concomitant ductal adenocarcinoma

Abstract

Patients with pancreatic ductal adenocarcinoma concomitant with IPMN-derived carcinoma are rare. We report a 75-year-old male patient followed-up for IPMN for seven years. The main pancreatic duct (MPD) at the pancreatic head was narrowed and the MPD at the pancreatic tail was noted to be dilated by MRCP. CT scan, MRI and EUS did not reveal tumor. Therefore, the patient underwent endoscopic retrograde cholangiopancreatography, and malignant cells were detected by cytology. Since malignant cells were detected in the head and tail of the pancreas, total pancreatectomy was performed. Pathology results revealed concomitant pancreatic ductal adenocarcinoma in the head of pancreas and IPMN-derived carcinoma in the tail of the pancreas. The patient was diagnosed with pancreatic cancer T1aN0M0 Stage IA with changes in the main pancreatic duct.