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Adenocarcinoma with intraductal papillary mucinous neoplasm arising in a duodenal heterotopic pancreas: a case report

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Abstract

A woman in her 70 s was diagnosed with a tumor in her duodenal wall during a routine visit for diabetes. She subsequently underwent subtotal stomach-preserving pancreatoduodenectomy. Histologically, the tumor was present mainly in the duodenal wall, and atypical cystic ducts were seen in the muscularis propria and subserosa. Invasive well-differentiated adenocarcinoma was seen in the duodenal submucosal and mucosal layers. Heterotopic pancreatic tissue was seen within the tumor, and atypical epithelium had proliferated and replaced the cystic ductal epithelium of the heterotopic pancreas. Therefore, adenocarcinoma with intraductal papillary mucinous neoplasm arising in duodenal heterotopic pancreas was the final histopathological diagnosis, which is considered rare.

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Abbreviations

IPMN:

Intraductal papillary mucinous neoplasm

US:

Ultrasound

MRI:

Magnetic resonance imaging

CT:

Computed tomography

EUS:

Endoscopic ultrasound

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Acknowledgements

We thank Dr. Akio Yanagisawa, Japanese Red Cross Kyoto Daiichi Hospital, for his expert histopathological advice regarding this tumor.

Author information

Authors and Affiliations

  1. Clinical Department of Pathology, Gunma University Hospital, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan

    Etsuko Hisanaga & Hayato Ikota

  2. Department of Internal Medicine, Kusunoki Hospital, 607-22 Fujioka, Fujioka, Gunma, 375-0024, Japan

    Etsuko Hisanaga & Hitoshi Takagi

  3. Department of Diagnostic Pathology, Graduate School of Gunma University, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan

    Takaaki Sano

  4. Clinical Department of Hepatobiliary and Pancreatic Surgery, Gunma University Hospital, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan

    Norio Kubo, Norihiro Ishii & Ken Shirabe

  5. Department of Pathology, Public Tomioka General Hospital, 2073-1 Tomioka, Tomioka, Gunma, 370-2393, Japan

    Junko Hirato

Authors
  1. Etsuko Hisanaga
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  2. Takaaki Sano
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  4. Norihiro Ishii
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Corresponding author

Correspondence to Etsuko Hisanaga.

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Conflict of interest

Etsuko Hisanaga, Takaaki Sano, Norio Kubo, Norihiro Ishii, Ken Shirabe, Hitoshi Takagi, Junko Hirato and Hayato Ikota declare that they have no conflict of interest.

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All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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

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Hisanaga, E., Sano, T., Kubo, N. et al. Adenocarcinoma with intraductal papillary mucinous neoplasm arising in a duodenal heterotopic pancreas: a case report. Clin J Gastroenterol 13, 1373–1382 (2020). https://doi.org/10.1007/s12328-020-01224-2

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  • DOI: https://doi.org/10.1007/s12328-020-01224-2

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