Signet-ring Cell Carcinoma Derived from a Main Duct-type Intraductal Papillary Mucinous Neoplasm of the Pancreas: A Case Report with Long-term Follow-up

We herein report the case of a 74-year-old man who underwent surgery 9 years after his initial visit and who was pathologically diagnosed with signet-ring cell carcinoma (SRCC) derived from a main-duct-type intraductal papillary mucinous neoplasm (MD-IPMN). At the first imaging examination, only a small pancreatic cyst with mild dilation of the main pancreatic duct (MPD) was detected in the pancreatic head. Eventually, MD-IPMN with mural nodules and MPD dilation (30 mm) developed in the pancreatic body, while the pancreatic head cyst remained unchanged. Total pancreatectomy was performed and the MD-IPMN was pathologically diagnosed as SRCC derived from an intestinal-type MD-IPMN.

[1]  Y. Noda,et al.  Branch Duct Intraductal Papillary Mucinous Neoplasms of the Pancreas Involving Type 1 Localized Autoimmune Pancreatitis with Normal Serum IgG4 Levels Successfully Diagnosed by Endoscopic Ultrasound-guided Fine-needle Aspiration and Treated without Pancreatic Surgery , 2017, Internal medicine.

[2]  M. Oikawa,et al.  Pancreatic juice cytology with immunohistochemistry to detect malignancy and histologic subtypes in patients with branch duct type intraductal papillary mucinous neoplasms of the pancreas. , 2017, Gastrointestinal endoscopy.

[3]  M. Büchler,et al.  Main-duct Intraductal Papillary Mucinous Neoplasm: High Cancer Risk in Duct Diameter of 5 to 9 mm. , 2015, Annals of surgery.

[4]  R. Sugita,et al.  Diffusion‐weighted magnetic resonance imaging for evaluating the histological degree of malignancy in patients with intraductal papillary mucinous neoplasm , 2014, Journal of hepato-biliary-pancreatic sciences.

[5]  Y. Fujinaga,et al.  Reappraisal of the Immunophenotype of Pancreatic Intraductal Papillary Mucinous Neoplasms (IPMNs)—Gastric Pyloric and Small Intestinal Immunophenotype Expression in Gastric and Intestinal Type IPMNs— , 2014, Acta histochemica et cytochemica.

[6]  H. Yokomizo,et al.  Localized type 1 autoimmune pancreatitis superimposed upon preexisting intraductal papillary mucinous neoplasms. , 2013, World journal of gastroenterology.

[7]  K. Higuchi,et al.  Potential predictors of disease progression for main‐duct intraductal papillary mucinous neoplasms of the pancreas , 2013, Journal of gastroenterology and hepatology.

[8]  D. Aust,et al.  Pathohistological Subtype Predicts Survival in Patients With Intraductal Papillary Mucinous Neoplasm (IPMN) of the Pancreas , 2013, Annals of surgery.

[9]  Jin-Young Jang,et al.  International consensus guidelines 2012 for the management of IPMN and MCN of the pancreas. , 2012, Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.].

[10]  T. Furukawa,et al.  Pancreatic Ductal Adenocarcinoma Derived From IPMN and Pancreatic Ductal Adenocarcinoma Concomitant With IPMN , 2011, Pancreas.

[11]  D. Sahani,et al.  Prognosis of invasive intraductal papillary mucinous neoplasm depends on histological and precursor epithelial subtypes , 2011, Gut.

[12]  G. Honda,et al.  Predictors of Malignancy and Natural History of Main-Duct Intraductal Papillary Mucinous Neoplasms of the Pancreas , 2011, Pancreas.

[13]  T. Ohtsuka,et al.  Invasive carcinoma derived from the nonintestinal type intraductal papillary mucinous neoplasm of the pancreas has a poorer prognosis than that derived from the intestinal type. , 2010, Surgery.

[14]  M. Kage,et al.  A case of invasive carcinoma derived from intraductal papillary‐mucinous carcinoma of the pancreas producing a signet ring‐type appearance on pancreatic duct brushing cytology , 2009, Cytopathology : official journal of the British Society for Clinical Cytology.

[15]  Kazuhiro Yoshida,et al.  Comparison of histologic subtype and growth pattern in intraductal papillary-mucinous carcinoma of the pancreas. , 2008, Oncology reports.

[16]  Y. Kanai,et al.  Minimally Invasive Intraductal Papillary-mucinous Carcinoma of the Pancreas: Clinicopathologic Study of 104 Intraductal Papillary-mucinous Neoplasms , 2008, The American journal of surgical pathology.

[17]  Masao Tanaka.  International consensus guidelines for the management of IPMN and MCN of the pancreas. , 2007, Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology.

[18]  W. Frankel,et al.  Mucin profiles in signet-ring cell carcinoma. , 2009, Archives of pathology & laboratory medicine.

[19]  R. Hruban,et al.  Classification of types of intraductal papillary-mucinous neoplasm of the pancreas: a consensus study , 2005, Virchows Archiv.

[20]  P. Chu,et al.  Immunohistochemical characterization of signet-ring cell carcinomas of the stomach, breast, and colon. , 2004, American journal of clinical pathology.

[21]  C. Bassi,et al.  Main-Duct Intraductal Papillary Mucinous Neoplasms of the Pancreas: Clinical Predictors of Malignancy and Long-term Survival Following Resection , 2004, Annals of surgery.