Poorly differentiated ductal adenocarcinoma of the pancreas with rapid progression in a young man

Clin J Gastroenterol. 2018 Oct;11(5):417-423. doi: 10.1007/s12328-018-0859-z. Epub 2018 Apr 16.


Pancreatic cancer in young adults is very rare. We report a case of young-onset poorly differentiated pancreatic ductal adenocarcinoma with rapid progression and poor prognosis in a 31-year-old Japanese man with no obvious family history of malignancy. Preoperative examinations revealed a mass lesion in the body of the pancreas, accompanied by a slightly dilated main pancreatic duct distal to the mass lesion. Pancreatic cancer with acute pancreatitis was suspected because of an elevation of serum pancreatic enzyme and tumor marker, along with imaging findings. Distal pancreatectomy with resection of the common hepatic artery and splenectomy along with lymph node dissection was performed. Microscopically, the tumor was mainly composed of poorly differentiated ductal adenocarcinoma. The postoperative course was uneventful, but the patient had multiple liver metastases 2 months postoperatively, in spite of adjuvant chemotherapy, and died 8 months postoperatively. This case may represent a rare instance of young-onset poorly differentiated ductal adenocarcinoma with rapid progression and may indicate potential risk factors of pancreatic cancer in young adults.

Keywords: Acute pancreatitis; Pancreatic cancer; Poorly differentiated ductal adenocarcinoma; Young.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Carcinoma, Pancreatic Ductal / complications
  • Carcinoma, Pancreatic Ductal / secondary
  • Carcinoma, Pancreatic Ductal / surgery*
  • Chemotherapy, Adjuvant
  • Disease Progression
  • Fatal Outcome
  • Hepatic Artery / surgery
  • Humans
  • Liver Neoplasms / secondary
  • Lymph Node Excision
  • Male
  • Pancreatectomy
  • Pancreatic Neoplasms / complications
  • Pancreatic Neoplasms / pathology
  • Pancreatic Neoplasms / surgery*
  • Pancreatitis / complications
  • Splenectomy