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Asymptomatic curable pancreatic ductal carcinoma detected during the follow-up of pancreatic cysts distinct from carcinoma

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Abstract

Recent studies have reported that pancreatic ductal carcinomas are frequently found during the follow-up of pancreatic cysts distinct from carcinoma; however, the majority of them are detected in advanced stages. Therefore, the early detection of metachronous ductal carcinomas is one of the issues in the management of pancreatic cysts. A 25-mm pancreatic cyst in the pancreatic head was found during an annual check-up in a 70-year-old woman. She was followed up every 6 months by abdominal ultrasound (US) and blood tests, and every 12 months by an additional magnetic resonance imaging scan. Twelve months later, abdominal US revealed a suspicious low-echoic area of 17 mm diameter in the pancreatic body. Eighteen months later, her serum carbohydrate antigen 19-9 level rose to 92 U/ml. Endoscopic retrograde pancreatography demonstrated a strictured main pancreatic duct (MPD) of 15 mm in length in the pancreatic body. A cytological examination of the brushed MPD revealed adenocarcinoma. The patient underwent distal pancreatectomy and splenectomy after chemoradiotherapy. An histological examination revealed a ductal carcinoma of 26 mm diameter in the pancreatic body, which was successfully resected. This case might help to establish an optimal surveillance method to detect metachronous ductal carcinomas arising from the pancreas harboring cystic lesions.

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Authors and Affiliations

  1. Department of Gastroenterology, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari, Osaka, 537-8511, Japan

    Natsuko Kawada, Hiroyuki Uehara, Kazuhiro Katayama, Kazuho Imanaka & Kazuyoshi Ohkawa

  2. Department of Cancer Survey, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari, Osaka, 537-8511, Japan

    Sachiko Tanaka, Rena Takakura, Yasuna Takano, Tatsuya Ioka & Miho Nakao

  3. Department of Cytology, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari, Osaka, 537-8511, Japan

    Akemi Takenaka

  4. Department of Pathology, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari, Osaka, 537-8511, Japan

    Yasuhiko Tomita

  5. Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari, Osaka, 537-8511, Japan

    Osamu Ishikawa

Authors
  1. Natsuko Kawada
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  2. Hiroyuki Uehara
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  3. Kazuhiro Katayama
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  4. Sachiko Tanaka
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  5. Rena Takakura
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  6. Yasuna Takano
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  7. Tatsuya Ioka
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  8. Miho Nakao
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  9. Kazuho Imanaka
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  10. Kazuyoshi Ohkawa
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  11. Akemi Takenaka
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  12. Yasuhiko Tomita
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  13. Osamu Ishikawa
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Corresponding author

Correspondence to Hiroyuki Uehara.

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Kawada, N., Uehara, H., Katayama, K. et al. Asymptomatic curable pancreatic ductal carcinoma detected during the follow-up of pancreatic cysts distinct from carcinoma. Clin J Gastroenterol 4, 135–139 (2011). https://doi.org/10.1007/s12328-011-0210-4

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  • DOI: https://doi.org/10.1007/s12328-011-0210-4

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