J Dig Cancer Res.  2019 Jun;7(1):18-21. 10.0000/jdcr.2019.7.1.18.

A Case of 47-Years-Old Female with Obstructive Jaundice and Weight Loss

Affiliations
  • 1Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. LHS6865@yuhs.ac

Abstract

Serine protease inhibitor Kazal-type 1 (SPINK1) is a gene expressed from pancreatic acinar cell which its mutation is known to be associated with chronic pancreatitis (CP) and pancreatic cancer. We report a case of a 47-years-old female with nausea and weight loss with yellow discoloration of skin. Initial imaging and endoscopic study led us to an impression of chronic pancreatitis with pancreatic cancer with common bile-duct dilation. Biopsy result was confirmed with pancreatic adenocarcinoma and additional imaging revealed lymph node and bone metastasis. Our genetic analysis revealed 194+2T>C mutation of SPINK1. Biliary obstruction was successfully decompressed by stent insertion and underwent chemotherapy and radiotherapy. Although there is accumulating evidence of association between SPINK1 mutation and CP, the relationship between SPINK1 mutation and pancreatic cancer in CP patient is an emerging concept. Genetic analysis should be considered in patients with young age especially when diagnosed with both CP and pancreatic cancer.

Keyword

Pancreatic cancer; Chronic pancreatitis; Idiopathic; Hereditary; SPINK1

MeSH Terms

Acinar Cells
Adenocarcinoma
Biopsy
Drug Therapy
Female*
Genes, vif
Humans
Jaundice, Obstructive*
Lymph Nodes
Nausea
Neoplasm Metastasis
Pancreatic Neoplasms
Pancreatitis, Chronic
Radiotherapy
Serine Proteases
Skin
Stents
Weight Loss*
Serine Proteases
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