Korean J Gastroenterol.  2006 Mar;47(3):218-223.

A Case of Intraductal Papillary Mucinous Neoplasm of the Pancreas Arising from Pancreas Divisum without Ventral Pancreatic Duct of Wirsung

Affiliations
  • 1Department of Internal Medicine, Eulji University School of Medicine, Eulji Hospital, Seoul, Korea. shkim@eulji.or.kr
  • 2Department of Pathology, Eulji University School of Medicine, Eulji Hospital, Seoul, Korea.
  • 3Department of Radiology, Eulji University School of Medicine, Eulji Hospital, Seoul, Korea.

Abstract

Most reported cases of intraductal papillary mucinous neoplasms (IPMNs) originate from Wirsung's duct or their branches. IPMNs arising from Santorini's duct and its branches have rarely been reported. Eight cases of IPMN arising from Santorini's duct have been published worldwide. However, these cases are associated with incomplete type of pancreas divisum. Recently, one report of IPMN with complete absence of Wirsung's duct has been reported. This patient was a 57-year-old woman who was admitted to the hospital due to progressive jaundice. On endoscopic retrograde cholangiopancreatography, there was a severely bulging ampulla of Vater and patulous minor papilla draining mucinous material and a cystic lesion communicating with the dilated Santorini's duct without any communication with Wirsung's duct. A pancreaticoduodenectomy was performed and the pathologic examination of resected specimen showed no evidence of Wirsung's duct, but an IPMN arising from Santorini's duct with peripancreatic lymph node metastasis. Herein, we report a case of invasive IPMN arising from pancreatic head without ventral pancreatic duct with a review of the relevant literatures.

Keyword

Intraductal papillary mucinous neoplasm; Ventral pancreatic duct; Chronic pancreatitis; Pancreas divisum
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