[A case of invasive intraductal papillary mucinous carcinoma arising from jejunal heterotopic pancreas]

Nihon Shokakibyo Gakkai Zasshi. 2022;119(5):452-458. doi: 10.11405/nisshoshi.119.452.
[Article in Japanese]

Abstract

Intraductal papillary mucinous carcinoma (IPMC) arising from the heterotopic pancreas is rare. A case of IPMC metastasis from the jejunal heterotopic pancreas was described. The heterotopic pancreas could be the source of the submucosal tumor-like lesion found in the small intestine with an elevated carbohydrate antigen (CA) 19-9 level. A 60-year-old woman was admitted to the hospital with pulmonary thromboembolism and anemia. The level of CA19-9, a tumor marker, was found to be 211.8U/ml. A tumor in the jejunum was discovered using contrast-enhanced computed tomography. There were also a number of hepatic tumors found. A submucosal tumor-like lesion in the jejunum was discovered during an enteroscopy, and a biopsy revealed it to be an adenocarcinoma. Partial resection of the jejunum was performed to control hemorrhage. Histopathology revealed an invasive IPMC arising from a heterotopic pancreas (Heinrich type II) and chemotherapy with gemcitabine and nab-paclitaxel was initiated. There have only been three cases of invasive IPMC from a heterotopic pancreas reported, and this is the first one to include chemotherapeutic treatment of distant metastasis.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma* / surgery
  • Adenocarcinoma, Mucinous* / diagnostic imaging
  • Adenocarcinoma, Mucinous* / surgery
  • Adenocarcinoma, Papillary* / surgery
  • Carcinoma, Pancreatic Ductal* / diagnostic imaging
  • Carcinoma, Pancreatic Ductal* / pathology
  • Carcinoma, Pancreatic Ductal* / surgery
  • Female
  • Humans
  • Jejunum / pathology
  • Middle Aged
  • Pancreas / diagnostic imaging
  • Pancreas / surgery
  • Pancreatic Neoplasms* / diagnostic imaging
  • Pancreatic Neoplasms* / pathology
  • Pancreatic Neoplasms* / surgery