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 23 June 2018

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Mucinous papillary carcinoma of the pancreas.

A 63-year old woman with an intraduct papillary mucinous adenocarcinoma of the pancreas. Twelve years earlier she had presented with obstructive jaundice. At that time the diagnosis of malignancy could not be established - even with multiple biopsies at open operation. At the first operation, the patient underwent biliary bypass with a Roux loop and a Puestow procedure.

On this occasion she presented with chronic pain and a CT scan showed a cystic mass in the head of the pancreas. She underwent a pancreaticoduodenectomy.

This photograph shows the opened specimen with the tumour encircling the ampulla. The histology of the resected lesion showed intraduct papillary mucinous adenocarcinoma with an extensive colloid component. There was in situ disease showing extensive involvement of pancreatic ducts as well as the common bile duct. In situ disease extended up to the resection margins of the both the common bile duct and the pancreatic duct. The surgical margins were apparently free from invasive carcinoma. These uncommon tumours are typically slow growing and a 12 year history is not unusual.
Peter Devitt, Adelaide, Australia

Mucinous papillary carcinoma of the pancreas.

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