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Widespread and multifocal carcinomas in situ (CISs) through almost the entire pancreas: report of a case with preoperative cytological diagnosis

  • Case Management and Clinical Consequences
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Abstract

Purpose

It is imperative for prognostic improvement of pancreatic cancer that we try to diagnose carcinoma in situ (CIS) of lesions, i.e., precursors of invasive ductal carcinomas (IDCs) at an early stage, because results of treatment of patients with IDCs themselves continue to be rather unsatisfactory.

Materials and results

We report here a case of a patient who received subtotal pancreatectomy for widespread and multifocal CISs of the pancreas after preoperative brushing cytology from the epithelium of dilated main pancreatic duct proved cancer-positive preoperatively.

Conclusions

From our experience, we conclude that examination for CIS of the pancreas must be recommended whenever dilatation of relatively large pancreatic ducts is found by ultrasound or computed tomography. We should therefore advance to magnetic resonance cholangiopancreatography or endoscopic retrograde cholangiopancreatography and then cytological and/or pathological assessment of the pancreatic duct whenever non-continuous narrowing, localized dilatation, or other irregularities are encountered.

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Acknowledgment

The authors thank Motoko Ikenaga, cytotechnologist at the Department of Cytology, Cancer Institute of the JFCR, Tokyo, Japan, for her invaluable support and advice.

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Authors and Affiliations

  1. Departments of Surgery, Cancer Institute of the JFCR, 3-10-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan

    Makoto Seki, Ken Hayashi, Hiroaki Gotoh, Rintaro Koga & Akio Saiura

  2. Department of Gastroenterological Endoscopy, Kasumigaseki-Building Clinic, 3-2-5 Kasumigaseki, Chiyoda-ku, Tokyo, 100-6012, Japan

    Eiji Ninomiya

  3. Department of Diagnostic Imaging, Cancer Institute of the JFCR, Tokyo, Japan

    Keiko Yamada

  4. Department of Pathology, Cancer Institute of the JFCR, Tokyo, Japan

    Masamichi Katori & Yo Kato

  5. Department of Internal Medicine, Akabane-Iwabuchi Hospital, 2-64-13 Akabane, Kita-ku, Tokyo, 115-0045, Japan

    Hiroyoshi Okamura

Authors
  1. Makoto Seki
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  2. Eiji Ninomiya
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  3. Ken Hayashi
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  4. Hiroaki Gotoh
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  5. Rintaro Koga
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  6. Akio Saiura
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  7. Keiko Yamada
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  8. Masamichi Katori
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  9. Yo Kato
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  10. Hiroyoshi Okamura
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Corresponding author

Correspondence to Makoto Seki.

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Seki, M., Ninomiya, E., Hayashi, K. et al. Widespread and multifocal carcinomas in situ (CISs) through almost the entire pancreas: report of a case with preoperative cytological diagnosis. Langenbecks Arch Surg 395, 589–592 (2010). https://doi.org/10.1007/s00423-009-0579-4

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  • DOI: https://doi.org/10.1007/s00423-009-0579-4

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