Intraductal tubular carcinoma in an adenoma of the main pancreatic duct of the pancreas head

Keita Itatsu, Tsuyoshi Sano, Nobuyoshi Hiraoka, Hidenori Ojima, Yu Takahashi, Yoshihiro Sakamoto, Kazuaki Shimada, Tomoo Kosuge

Research output: Contribution to journalArticlepeer-review

29 Citations (Scopus)


A 50-year-old woman presented with intermittent diarrhea and upper abdominal pain. Laboratory data showed elevated serum amylase and elastase-I levels. Further image studies revealed a small, well-defined nodular lesion (8 mm in diameter) without mucin hypersecretion in the main pancreatic duct (MPD) of the pancreatic head and subsequent dilatation of the distal main pancreatic duct. A pylorus-preserving pancreatoduodenectomy with regional lymphadenectomy was performed. Microscopically, the tumor was an intraductal tubular carcinoma (ITC) in a tubular adenoma, suggesting direct histologic evidence of the adenoma-carcinoma sequence in intraductal tubular tumors, differing from previous reports of ITCs describing de novo-like development. The prognosis for ITC patients is sometimes dismal; therefore, early detection and appropriate surgical resection are mandatory to achieve long-term survival in ITC patients. MPD dilatation is a crucial sign and clue enabling the early detection of tiny pancreatic tumors.

Original languageEnglish
Pages (from-to)702-705
Number of pages4
JournalJournal of gastroenterology
Issue number7
Publication statusPublished - 2006 Jun
Externally publishedYes


  • Adenomato carcinoma sequence
  • Intraductal papillary mucinous neoplasms
  • Intraductal tubular carcinoma
  • Pancreas

ASJC Scopus subject areas

  • Gastroenterology


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