Korean Journal of Gastrointestinal Endoscopy 2000;20(6): 481-485.
증례 : 재발성 급성 췌장염을 계기로 발견된 췌장의 미소 Intraducta Papillary Mucinous Tumor 1예 ( A Case of Minute Intraductal Papillary Mucinous Tumor of the Pancreas Presenting with Recurrent Acute Pancreatitis )
지상원(Sang Won Chi),정준표(Jun Pyo Chung),박영년(Young Nyun Park),이세준(Se Joon Lee),이관식(Kwan Sik Lee),송시영(Si Young Song),정재복(Jae Bock Chung),이상인(Sang In Lee),강진경(Jin Kyung Kang),박준균(Jun Kyun Park),김기황(Ki Whang Kim),지훈상(Hoon Sang Chi)
Abstract
Intraductal papillary mucinous tumors (IPMT) of the pancreas is a lesion consisting of mucin-producing cells with neoplastic potential. This unique group of tumors is characterized by duct ectasia, mucin hypersecretion, often extensive papillary intraductal growth, varying degrees of cytologic atypia, and relatively indolent growth. Now IPMT of the pancreas also includes intraductal papillary neoplasms that do not hypersecrete mucin. The clinical presentation of IPMT of the pancreas is characterized by chronic or recurrent attacks of abdominal discomfort often in association with low level pancreatic enzyme elevations. The episodes of pancreatitis due to IPMT of the pancreas are mild in severity. Recently, we was experienced a case of a minute IPMT causing repeated bouts of acute pancreatitis in a 75 year-old man. An endoscopic retrograde pancreatogram revealed a filling defect at the neck of the main pancreatic duct. A near-total pancreatectomy was performed and a minute (3×7 mm) IPMT of borderline malignancy was found in a branch duct at the pancreatic head. Surprisingly, despite the resective surgery the patient died of carcinomatosis. 8.5 months after the operation. This case of a minute but aggressive IPMT of the pancreas is herein reported with a review of the relevant literature. (Korean J Gastrointest Endosc 2000;20:481 -485)
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