Uesato M, Nabeya Y, Miyazaki S, Aoki T, Akai T, Shuto K, Tanizawa T, Miyazaki M, Matsubara H. Postoperative recurrence of an IPMN of the pancreas with a fistula to the stomach. World J Gastrointest Endosc 2010; 2(10): 349-351 [PMID: 21160585 DOI: 10.4253/wjge.v2.i10.349]
Corresponding Author of This Article
Masaya Uesato, MD, Department of Frontier Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8677, Japan. uesato@faculty.chiba-u.jp
Article-Type of This Article
Case Report
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Masaya Uesato, Yoshihiro Nabeya, Takashi Akai, Kiyohiko Shuto, Hisahiro Matsubara, Department of Frontier Surgery, Chiba University Graduate School of Medicine, Chiba 260-8677, Japan
Shinichi Miyazaki, Taito Aoki, Makuhari Gastrointestinal Clinic, Chiba 262-0033, Japan
Masaru Miyazaki, Department of General Surgery, Chiba University Graduate School of Medicine, Chiba 260-8677, Japan
Tohru Tanizawa, Department of Pathology, Chiba University Hospital, Chiba 260-8677, Japan
Author contributions: Uesato M performed the gastroscopy and wrote this paper with Nabeya Y; Shuto K diagnosed the findings on computed tomography; Miyazaki M performed the operation; Tanizawa T diagnosed the pathological findings; and all of the authors contributed to the patient’s care and the discussion of his management.
Correspondence to: Masaya Uesato, MD, Department of Frontier Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8677, Japan. uesato@faculty.chiba-u.jp
Telephone: +81-43-2262110 Fax: +81-43-2262113
Received: April 16, 2010 Revised: July 13, 2010 Accepted: July 20, 2010 Published online: October 16, 2010
Abstract
We report on a case of a 74 year old man who was diagnosed with a recurrence of non-invasive carcinoma of intraductal papillary mucinous neoplasm (non-invasive IPMN) by postoperative gastroscopy (GS). A pylorus preserving pancreatico duodenectomy for IPMN in the pancreatic head was performed. A histopathological study revealed non-invasive adenocarcinoma. At first, the local recurrence of the tumor around the superior mesenteric artery circumference was diagnosed and disappeared with gemcitabine. Later, the GS showed the elevated lesion with mucin hypersecretion in the remnant stomach. The lesion had a central dip and a fistula common to the pancreas was confirmed on fisterography. We diagnosed a recurrence of IPMN and administered chemotherapy again. However, he died of his original illness. There are no reports of postoperative recurrence of IPMN checked by GS. It should be remembered that the elevated lesion of the remnant stomach is considered as one of the recurrent patterns of IPMN.
