MALIGNANT TRANSFORMATION OF INTRADUCTAL PAPILLARY MUCINOUS NEOPLASM OF THE PANCREAS: A NEW CASE REPORT

*Dr. Faten Limaiem and Saadia Bouraoui

ABSTRACT

Intraductal papillary mucinous neoplasms (IPMN) are a heterogeneous group of mucin producing cystic tumours that involve the main pancreatic duct and/or branch ducts and may be associated with invasive carcinoma. A 71 year-old male patient with a past medical history of hypertension and ischemic heart disease, presented with paroxysmal epigastralgia, weight loss, asthenia and steatorrhea. Abdominal computed CT scan showed a cystic lesion of the pancreas communicating with an accessory pancreatic duct associated with segmental dilation of the wirsung duct. The preoperative diagnosis was mixed type IPMN. The patient underwent pancreatoduodenectomy. Histopathological examination of the surgical specimen coupled with immunohistochemical study established the diagnosis of intestinal type IPMN associated with invasive ductal adenocarcinoma. Postoperative course was uneventful. At present, the patient is still being followed-up. Despite recent advanced technologies, diagnosis of IPMN is still challenging, especially in western countries due to its rarity. Early identification and resection of lesions, even in asymptomatic or minimally symptomatic patients, are however important prognostic factors.

Keywords: Pancreas, pathology, intraductal papillary mucinous neoplasm, malignant transformation.