Difficulty with diagnosis of malignant pancreatic neoplasms coexisting with chronic pancreatitis

Ting Kai Leung, Chi Ming Lee, Fong Chieh Wang, Hsin Chi Chen, Hung Jung Wang

研究成果: 雜誌貢獻回顧型文獻同行評審

13 引文 斯高帕斯(Scopus)

摘要

Chronic pancreatitis is a relatively common disease. We encountered two different cases of belatedly demonstrated pancreatic carcinoma featuring underlying chronic pancreatitis. The first case was one that was highly suspected as that of a malignancy based upon imaging study, but unfortunately, it could not be confirmed by intra-operative cytology at that time. Following this, the surgeon elected to perform only conservative bypass surgery for obstructive biliary complication. Peritoneal carcinomatosis was later noted and the patient finally died. The second case, a malignant mucinous neoplasm, was falsely diagnosed as a pseudocyst, based upon the lesion's sonographic appearance and associated elevated serum amylase levels. After suffering repeated hemoptysis, the patient was found to exhibit lung metastasis and peritoneal seeding. We reviewed some of the literature, including those studies discussing chronic pancreatitis predisposing to a malignant change. These two case analyses illustrate clearly that the diagnosis for such conditions, which is simply based upon imagery or pathological considerations may end up being one of a mistaken malignancy. Some of our suggestions for the treatment of such malignancies as revealed herein include, total pancreatomy for univocal mass lesion, and needle aspiration of lesion-contained tissue for amylase, CA199 and CEA levels for a suspicious cystic pancreatic mass.
原文英語
頁(從 - 到)5075-5078
頁數4
期刊World Journal of Gastroenterology
11
發行號32
DOIs
出版狀態已發佈 - 八月 28 2005

ASJC Scopus subject areas

  • 消化內科

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