2023 Volume 38 Issue 4 Pages 286-294
A 73-year-old woman presenting with liver dysfunction and dilatation of the common bile duct and intrahepatic bile ducts was referred for further examination and treatment. Imaging revealed a mass protruding into the pancreaticoduodenal groove, and endoscopic retrograde cholangiopancreatography with biliary brush cytology yielded Class V [malignancy] findings. Levels of tumor markers were also high, and the patient was diagnosed with pancreatic groove cancer. After preoperative chemotherapy, a pylorus-sparing pancreaticoduodenectomy was performed, and pancreatic groove cancer was definitively identified based on pathological examination. Here, 20 cases of pancreatic groove cancer reported in Japan are reviewed including the above case, to examine methods of preoperative diagnosis, pathological features, and prognosis. Pathologically, all cases displayed duodenal invasion, and common bile duct invasion was noted in 55.6% of cases. Duodenal mucosal biopsy, biliary pathology, and ultrasound endoscopy are helpful in preoperative diagnosis, but depending on imaging and endoscopic findings, multiple methods of diagnosis need be considered. In addition, the prognosis for patients with pancreatic groove cancer suggests possible benefits from combined-modality therapy as with typical pancreatic ductal carcinoma.
