A case of pancreatobiliary-type intraductal papillary mucinous carcinoma of the entire pancreas with minimal invasion presenting significant dilation of the main pancreatic duct

Abstract

A 71-year-old woman presented with pointed pancreatic swelling on abdominal ultrasonography. On further examination revealed elevated CA19-9. Moreover, computed tomography, magnetic resonance cholangiopancreatography, and endoscopic ultrasound scans revealed a 15cm long intraductal tumor spreading through almost the entire pancreas with significant main pancreatic duct dilation of 25mm. Notably, the results of both biopsy of the exposed papillary tumor from the Vater papilla and cytology of pancreatic juice indicated adenocarcinoma, with no lymphatic and distant metastases; thus, a total pancreatectomy was performed. Furthermore, histological examination of the patient revealed a tumor comprising atypical epithelium arranged in a complex papillary architecture with minimal pancreatic parenchymal invasion. On immunohistochemistry, tumor cells were diffuse positive for MUC1 and MUC5AC, partially positive for MUC6, and negative for MUC2. These findings indicated the diagnosis of pancreatobiliary-type intraductal papillary mucinous carcinoma. Briefly, this case report presents a case of pancreatobiliary-type intraductal papillary mucinous carcinoma of the entire pancreas with minimal invasion presenting significant dilation of the main pancreatic duct.