Hisa T, Ohkubo H, Shiozawa S, Ishigame H, Takamatsu M, Furutake M, Nobukawa B, Suda K. Growth process of small pancreatic carcinoma: A case report with imaging observation for 22 months. World J Gastroenterol 2008; 14(12): 1958-1960 [PMID: 18350642 DOI: 10.3748/wjg.14.1958]
Corresponding Author of This Article
Takeshi Hisa, MD, PhD, Department of Internal Medicine, Saku Central Hospital, 197 Usuda, Saku, Nagano 384-0301, Japan. thisa@r8.dion.ne.jp
Article-Type of This Article
Case Report
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Takeshi Hisa, Masato Takamatsu, Masayuki Furutake, Department of Internal Medicine, Saku Central Hospital, Nagano 384-0301, Japan
Hiroki Ohkubo, Department of Surgery, Saku Central Hospital, Nagano 384-0301, Japan
Satoshi Shiozawa, Hiroki Ishigame, Department of Clinical Pathology, Saku Central Hospital, Nagano 384-0301, Japan
Bunsei Nobukawa, Department of Human Pathology, Juntendo University School of Medicine, Tokyo, Japan
Koichi Suda, Department of Pathology, Tokyo-West Tokusyukai Hospital, Tokyo, Japan
Correspondence to: Takeshi Hisa, MD, PhD, Department of Internal Medicine, Saku Central Hospital, 197 Usuda, Saku, Nagano 384-0301, Japan. thisa@r8.dion.ne.jp
Telephone: +81-267-823131
Fax: +81-267-829638
Received: September 20, 2007 Revised: December 8, 2007 Published online: March 28, 2008
Abstract
This report describes serial observations of the growth process of a small invasive ductal carcinoma (IDC) of the pancreas from imaging studies. Histopathological studies showed IDC with macroscopic retention cysts proximal to an intraductal papillary-mucinous adenoma with mild atypia of the branch duct type in the pancreatic body, with no relation between the two lesions. IDC was demonstrated as an extremely low-echoic mass resembling a cyst with an unclear margin on the initial endoscopic ultrasonography. We misinterpreted the low-echoic mass as a benign intraductal mucinous-papillary neoplasm (IPMN) based on findings of other imaging studies, and the patient was followed-up. The mass increased from 7 mm to 13 mm in diameter over 22 mo, and remained smaller than 10 mm in diameter for about 420 d. The tumor volume doubling time was 252 d. The Ki67 labeling index was 15.9%, similar to that described in previous reports. Hence, IDC may grow slowly while remaining small.
