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An extremely rare case who underwent total remnant pancreatectomy due to recurrent pancreatic metastasis of intraductal tubulopapillary neoplasm

  • Akira Umemura
  • Kazuyuki Ishida
  • Hiroyuki Nitta
  • Takeshi Takahara
  • Yasushi Hasegawa
  • Kenji Makabe
  • Tamotsu Sugai
  • Akira Sasaki
Case Report
  • 56 Downloads

Abstract

We describe a rare case of recurrent pancreatic metastasis of intraductal tubulopapillary neoplasm (ITPN). A 53-year-old woman diagnosed with an intraductal papillary mucinous neoplasm (IPMN) and a pancreatic ductal adenocarcinoma (PDAC) of the pancreatic body underwent a distal pancreatectomy. The tumor was composed of cuboidal, high-grade dysplastic cells proliferating in a tubulopapillary growth pattern without mucin production; hence, the final diagnosis was ITPN. A follow-up computed tomography scan revealed an enhanced 2 cm mass of the pancreatic head 3 years after the surgery. From workup investigations, the patient was diagnosed with PDAC or a recurrent ITPN of the remnant pancreas. A total remnant pancreatectomy was then performed. Histopathological findings revealed that the new ITPN had the same features as the prior ITPN. In IPMNs, the presence of an invasive component and high-grade dysplasia can lead to progression to a recurring IPMN and the development of PDAC. Because there have been few reports of recurrent ITPN developing into PDAC, the risk factors for ITPN have not been investigated. Because of the uncertain clinicopathological characteristics of ITPN, more data should be gathered to assess the long-term outcome and malignant potential of ITPN.

Keywords

Intraductal tubulopapillary neoplasm Pancreatic intraductal neoplasm Tubulopapillary growth Recurrence 

Notes

Acknowledgements

We gratefully acknowledge the technical assistance of members of the Department of Molecular Diagnostic Pathology, Iwate Medical University.

Compliance with ethical standards

Conflict of interest

Akira Umemura and all the co-authors have no conflict of interest.

Human/animal rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008(5).

Informed consent

Informed consent was obtained from the patient for being included in the study.

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Copyright information

© Japanese Society of Gastroenterology 2018

Authors and Affiliations

  1. 1.Department of SurgeryIwate Medical UniversityMoriokaJapan
  2. 2.Department of Molecular Diagnostic PathologyIwate Medical UniversityMoriokaJapan

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