Total Pancreaticoduodenectomy and Segmental Resection of Superior Mesenteric Vein-Portal Vein Confluence with Autologous Splenic Vein Graft in Mucinous Cystadenocarcinoma of the Pancreas

  • Sung Hoon Choi Division of Biliopancreas, Department of Surgery, Yonsei University College of Medicine and Pancreatobiliary Cancer Clinic, Institute of Gastroenterology, Yonsei University Health System. Seoul, Korea
  • Ho Kyoung Hwang Division of Biliopancreas, Department of Surgery, Yonsei University College of Medicine; Pancreatobiliary Cancer Clinic, Institute of Gastroenterology, Yonsei University Health System; Young Yonsei Pancreatic Tumor Study Group. Seoul, Korea
  • Chang Moo Kang Division of Biliopancreas, Department of Surgery, Yonsei University College of Medicine; Pancreatobiliary Cancer Clinic, Institute of Gastroenterology, Yonsei University Health System; Young Yonsei Pancreatic Tumor Study Group. Seoul, Korea
  • Woo Jung Lee Division of Biliopancreas, Department of Surgery, Yonsei University College of Medicine and Pancreatobiliary Cancer Clinic, Institute of Gastroenterology, Yonsei University Health System. Seoul, Korea
DOI: https://doi.org/10.6092/1590-8577/3414
Keywords: Cystadenocarcinoma, Mucinous, Head, Male

Abstract

Context Mucinous cystic tumors occur almost exclusively in middle-aged women and in the body or tail of the pancreas. Mucinous cystadenocarcinoma, a malignant sub-type of mucinous cystic tumors, in the head of the pancreas and in a middle-aged man is extraordinary, and the prognosis and proper management of mucinous cystadenocarcinoma has not been well documented. Case report A 52-year-old male patient with a mucinous cystadenocarcinoma approximately 5.5 cm in size in the head of the pancreas underwent a total pancreaticoduodenectomy and segmental resection of the superior mesenteric vein-portal vein confluence with an autologous splenic vein graft due to tumor invasion. His postoperative course was uneventful and he received adjuvant chemotherapy. He has been followed-up periodically for more than 30 months after surgery without evidence of recurrence. Conclusion Mucinous cystadenocarcinoma in the head of the pancreas in a middle-aged man is an extremely rare case. Because mucinous cystadenocarcinomas have a relatively good prognosis, an aggressive approach with major vascular resection is warranted in well-selected patients. Splenic vein interposition grafting could be used in cases which undergo total pancreaticoduodenectomy with segmental resection of the superior mesenteric vein-portal vein confluence if the splenic vein is healthy.

Image: Preoperative studies.

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Preoperative studies
Published
2010-11-09
How to Cite
ChoiS., HwangH., KangC., & LeeW. (2010). Total Pancreaticoduodenectomy and Segmental Resection of Superior Mesenteric Vein-Portal Vein Confluence with Autologous Splenic Vein Graft in Mucinous Cystadenocarcinoma of the Pancreas. JOP. Journal of the Pancreas, 11(6), 638-641. https://doi.org/10.6092/1590-8577/3414
Issue
Vol 11 No 6 (2010): November - p. 536-669
Section
CASE REPORTS

Copyright (c) 2010 Sung Hoon Choi, Ho Kyoung Hwang, Chang Moo Kang, Woo Jung Lee

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