Abstract
The prognosis of intraductal papillary-mucinous neoplasm is superior to that of conventional pancreatic ductal adenocarcinoma. Only a few advanced cases of intraductal papillary-mucinous carcinoma (IPMC) have been reported to date. We herein report the case of a 78-year-old male patient with advanced pancreatobiliary type IPMC with portal vein invasion and liver metastasis. The IPMC invaded the portal vein to form a tumor thrombus and it also metastasized to the liver via the portal vein. After receiving best supportive care, the patient succumbed to the disease following an exacerbation of IPMC 90 days after the initial presentation. On autopsy, a very long tumor thrombus was identified, along with liver metastatic lesions, which had retained the structure of the primary IPMC on histological examination.
Highlights
Intraductal papillary‐mucinous neoplasm (IPMN) of the pancreas is a cystic tumor arising from the cells lining the pancreatic ducts
The pancreatic tumor metastasized to the liver via the portal vein, retained the intraductal papillary‐mucinous carcinoma (IPMC) structure and produced mucus
Invasive IPMN is consid‐ ered to have a better prognosis compared with conventional pancreatic ductal adenocarcinoma (PDAC) [7,8]
Summary
We report a case of a pancreatobiliary type IPMC with formation of a portal vein tumor thrombus and multifocal liver metastasis. An abdominal plain computed tomog‐ raphy (CT) scan at the hospital revealed dilatation of the bile ducts and the presence of cystic lesions in the pancreatic head and liver, and the patient was referred to Saiseikai Chuwa Hospital (Sakurai, Japan) for further examination and treatment. The common bile duct was obstructed due to the polycystic tumor in the pancreatic head and was dilated to 20 mm. On the CT scan, the common bile duct was obstructed by the polycystic tumor in the pancreatic head and was dilated to a width of 20 mm. The pancreatic head tumor had not metastasized to the regional lymph nodes, but rather directly metastasized to the liver via the portal vein, retaining the IPMC structure and mucus production
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