A case of intraductal papillary mucinous neoplasm of the pancreas rupturing both the stomach and duodenum

Gastrointest Endosc. 2010 Feb;71(2):406-12. doi: 10.1016/j.gie.2009.09.018. Epub 2009 Nov 17.

Abstract

Background: Intraductal papillary mucinous neoplasm (IPMN) of the pancreas may extend to other organs. However, it is rare for a histopathologically benign IPMN to rupture other organs, particularly multiple organs. There has been no report of a benign IPMN rupturing both the stomach and duodenum.

Objective: We experienced a very rare case and make personal remarks based on bibliographical consideration.

Design: Case report.

Setting: National Defense Medical College.

Patient: A patient with IPMN.

Intervention: EGD, ERCP, and pancreatoduodenectomy.

Conclusions: We report a case of benign IPMN of the pancreas extending to two adjacent organs. A 77-year-old male who was diagnosed as having IPMN by CT, MRI, upper GIF, and ERCP underwent pancreatoduodenectomy for a mass of 4.2 cm in diameter. Pathological examinations revealed that the IPMN was composed of adenoma. Intraluminal nodular growth was observed in the duodenal gland tissue, and abnormal growth was observed in the fistula to the stomach. According to a literature review based on PubMed data up until March 2009, it is rare for a benign IPMN to penetrate two adjacent organs.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adenocarcinoma, Mucinous / secondary*
  • Adenocarcinoma, Mucinous / surgery
  • Aged
  • Carcinoma, Pancreatic Ductal / secondary*
  • Carcinoma, Pancreatic Ductal / surgery
  • Carcinoma, Papillary / secondary*
  • Carcinoma, Papillary / surgery
  • Cholangiopancreatography, Endoscopic Retrograde / methods
  • Duodenal Neoplasms / complications
  • Duodenal Neoplasms / secondary*
  • Duodenal Neoplasms / surgery
  • Endosonography / methods
  • Follow-Up Studies
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Neoplasm Invasiveness / pathology
  • Pancreatic Neoplasms / pathology*
  • Pancreatic Neoplasms / surgery
  • Pancreaticoduodenectomy / methods
  • Rare Diseases
  • Risk Assessment
  • Rupture, Spontaneous / etiology
  • Rupture, Spontaneous / surgery
  • Stomach Neoplasms / complications
  • Stomach Neoplasms / secondary*
  • Stomach Neoplasms / surgery
  • Tomography, X-Ray Computed
  • Treatment Outcome