A Minute Pancreatic Ductal Adenocarcinoma with Lipomatous Pseudohypertrophy of the Pancreas
Abstract
Context This report describes a minute pancreatic ductal adenocarcinoma that appeared to be very early stage in the tumor progression from the study of the molecular abnormalities. Moreover, lipomatous pseudohypertrophy, a rare disease, was shown in synchrony.
Case report A 78-year-old male was admitted to our department due to an incidental pancreatic tumor. Abdominal dynamic computed tomography showed an enlarged pancreas and diffuse fat-low density in the whole pancreas was demonstrated. In the pancreatic body, a slightly enhanced 10 mm mass in the early phase was shown. He underwent a distal pancreatectomy. The histological features of the tumor revealed abundant fibrosis and duct lesions with various atypia. Duct lesions equivalent to well differentiated adenocarcinoma were shown sparsely, but no vessel or lymphatic permeation nor perineural invasion were observed. In the background pancreas, diffuse fatty infiltrations that were composed of abundant normal adipose tissue and scattered pancreatic parenchyma were shown. The results of immunolabeling for MUC1, p16, p53, and Smad4 demonstrated that there is a possibility of coexistence of precancerous duct lesions and cancerous ones in the genetic progression of pancreatic cancer.
Conclusion Above results suggested that this pancreatic ductal adenocarcinoma with lipomatous pseudohypertrophy might be very early stage in the tumor progression.
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References
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Copyright (c) 2014 Sadanobu Izumi
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