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Intraductal papillary mucinous carcinoma of the pancreas associated with pancreas divisum: a case report and review of the literature

Overview of attention for article published in BMC Gastroenterology, July 2015
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Title
Intraductal papillary mucinous carcinoma of the pancreas associated with pancreas divisum: a case report and review of the literature
Published in
BMC Gastroenterology, July 2015
DOI 10.1186/s12876-015-0313-3
Pubmed ID
Authors

Takeshi Nishi, Yasunari Kawabata, Noriyoshi Ishikawa, Asuka Araki, Seiji Yano, Riruke Maruyama, Yoshitsugu Tajima

Abstract

Pancreas divisum, the most common congenital anomaly of the pancreas, is caused by failure of the fusion of the ventral and dorsal pancreatic duct systems during embryological development. Although various pancreatic tumors can occur in patients with pancreas divisum, intraductal papillary mucinous neoplasm is rare. A 77-year-old woman was referred to our hospital because she was incidentally found to have a cystic tumor in her pancreas at a regular health checkup. Contrast-enhanced abdominal computed tomography images demonstrated a cystic tumor in the head of the pancreas measuring 40 mm in diameter with slightly enhancing mural nodules within the cyst. Endoscopic retrograde pancreatography via the major duodenal papilla revealed a cystic tumor and a slightly dilated main pancreatic duct with an abrupt interruption at the head of the pancreas. The orifice of the major duodenal papilla was remarkably dilated and filled with an abundant extrusion of mucin, and the diagnosis based on pancreatic juice cytology was "highly suspicious for adenocarcinoma". Magnetic resonance cholangiopancreatography depicted a normal, non-dilated dorsal pancreatic duct throughout the pancreas. The patient underwent a pylorus-preserving pancreaticoduodenectomy under the diagnosis of intraductal papillary mucinous neoplasm with suspicion of malignancy arising in the ventral part of the pancreas divisum. A pancreatography via the major and minor duodenal papillae on the surgical specimen revealed that the ventral and dorsal pancreatic ducts were not connected, and the tumor originated in the ventral duct, i.e., the Wirsung's duct. Microscopically, the tumor was diagnosed as intraductal papillary mucinous carcinoma with microinvasion. In addition, marked fibrosis with acinar cell depletion was evident in the ventral pancreas, whereas no fibrotic change was noted in the dorsal pancreas. Invasive ductal carcinomas of the pancreas associated with pancreas divisum usually arise from the dorsal pancreas, in which the occurrence of pancreatic cancer may link to underlying longstanding chronic pancreatitis in the dorsal pancreas; however, the histopathogenesis of intraductal papillary mucinous neoplasm in this anomaly is a critical issue that warrants further investigation in future.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 12 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 12 100%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 3 25%
Other 2 17%
Student > Bachelor 2 17%
Unspecified 2 17%
Researcher 1 8%
Other 2 17%
Readers by discipline Count As %
Medicine and Dentistry 9 75%
Unspecified 2 17%
Biochemistry, Genetics and Molecular Biology 1 8%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 11 July 2015.
All research outputs
#4,444,492
of 5,339,107 outputs
Outputs from BMC Gastroenterology
#514
of 609 outputs
Outputs of similar age
#149,703
of 185,798 outputs
Outputs of similar age from BMC Gastroenterology
#41
of 41 outputs
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