Mucin-producing adenoma associated with pancreas divisum and hepatic hilar carcinoma: An autopsy case |
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Authors: | Nobuto Origuchi Wataru Kimura Tetsuichiro Muto Yukiyoshi Esaki |
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Institution: | (1) Present address: First Department of Surgery, Faculty of Medicine, University of Tokyo, 7-3-1 Hongo Bunkyo-ku, 113 Tokyo, Japan;(2) Department of Pathology, Tokyo Geriatric Hospital, Tokyo, Japan;(3) Department of Clinical Pathology, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan |
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Abstract: | We present the autopsy case of an 82-year-old Japanese woman with a mucin-producing adenoma accompanied by pancreas divisum
and a hepatic hilar carcinoma. She had suffered from a cholangiocellular carcinoma at the hepatic hilus for 2 months, which
was treated with radiation and chemotherapy. She did not complain of any abdominal pain. Obstructive jaundice deteriorated
despite percutaneous transhepatic bile duct drainage, and she died of hepatic insufficiency. At autopsy, a hepatic tumor was
confirmed to have caused severe obstructive jaundice. Histological examinations showed moderately to poorly differentiated
cholangiocellular adenocarcinoma with squamous metaplasia, probably due to radiation. A yellowish mucinous tumor was found
in the head of the pancreas near the minor papilla. It consisted of multiple rice-sized cystic lesions with thin septa. Although
it had no capsule, its margin was clear. Neither a wide opening of the major or minor papilla nor mucous drainage was observed.
Gross examinations revealed unfused pancreatic ducts. The slightly dilated dorsal duct and a branch of the mildly dilatated
ventral duct showed tumor involvement. Histological examinations showed mild atypia of the epithelia, and this pancreatic
tumor was diagnosed as branch duct-type mucin-producing adenoma with postradiation dysplasia. The combination of a mucin-producing
tumor and pancreas divisum is rare, and this is only the third reported case. |
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Keywords: | ulcer head of the pancreas dorsal duct branch duct type postradiation dysplasia |
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