A Case of Giant Mucinous Cystadenocarcinoma of the Pancreas

Abstract

A 26-year-old woman was admitted to our hospital because of abdominal distension, nausea and vomiting lasting for one week. A soft elastic mass of an infant head in size was present at upper abdomen. Computed tomography (CT) showed a giant multilocular cyst over 25 cm in diameter with enhanced nodule on cystic wall adhering to the pancreatic body and tail. Under a preoperative diagnosis of mucinous cystadenocarcinoma of the pancreas, we conducted operation. A giant tumor with a smooth capsule was revealed, and was partly adhering to gastric wall. We surgically resected the tumor with partial gastrectomy and distal pancreatectomy. Macroscopic findings of the resected specimen showed that the cystic tumor had thin septums with irregular nodule 3.5 cm in size toward the lumen. Although histopathological diagnosis was minimally invasive mucinous cystadenocarcinoma with ovarian-like stroma, it was assumed that the tumor contained highly malignant potential because of remarkable invasion to the lymphatic vessels and anaplastic component in the nodule. Though the patient is currently receiving chemotherapy with gemcitabine, no recurrence has been observed two years after the surgery. We report a relatively rare case of mucinous cystadenocarcinoma of the pancreas over 25 cm in size together with some discussion of the literature.