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Preoperative computed tomography (CT). (a) Yellow arrow indicates poorly enhanced tumor of the pancreatic body. (b) Red arrow indicates the dilated main pancreatic duct.
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Two and a half years after resection, CT revealed a hypovascular mass accompanied with dilation of the peripheral pancreatic duct in the pancreatic body (Fig. 1).
(a) Gross appearance of the resected specimen. The dimensions were 25 x 20 x 25 mm3 (b, c) Histopathological appearance of the primary gastric cancer (b) and resected pancreatic tumor (c). Photograph revealing that both tumors were composed of poorly differentiated adenocarcinoma cells, mixed with moderately differentiated tubular adenocarcinoma cells. (d) Histopathological appearance of invasive ductal carcinoma. Well-differentiated adenocarcinoma found in the pancreatic duct.
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The resected tumor measured 25 x 20 x 25 mm3 and was a white to yellowish, firm mass (Fig. 2a) Microscopy revealed poorly differentiated adenocarcinoma cells mixed with moderately differentiated tubular adenocarcinoma cells whose features were inconsistent with the gastric cancer specimen resected earlier (Fig. 2b, c). Proximal to the metastasis of the gastric cancer, 7 mm distal from the stump, well-differentiated tubular adenocarcinoma existed in the pancreatic duct and invaded surrounding tissues (Fig. 2d).