PMC7184847_01
Histopathologic findings of the resected specimen. A Specimen from the initial operation showed an aplastic carcinoma with osteoclast-like large cells. B Specimen from the second operation showed a well-differentiated tubular adenocarcinoma with glandular formation. C Specimen from the third operation showed an aplastic carcinoma similar to that of the initial operation.
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F1
Pathological examination of the third tumor showed components of aplastic carcinoma similar to the microscopic findings of the specimen from the first operation (Fig. 1C).
Images of the second operation. A Contrast-enhanced CT showing a small low-density lesion (10 mm in diameter) in the tail of the residual pancreas (arrow). B MRI showing small nodules in the tail of the pancreas (arrow), which had a low intensity on a T1-weighted image and iso-intensity on a T2-weighted image. The nodule was not enhanced by gadolinium EDTA.
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F2
Moreover, a small nodular lesion measuring 9 mm in diameter was observed in the tail of the residual pancreas on computed tomography (CT) (Fig. 2A) and magnetic resonance imaging (MRI) (Fig. 2B). 19F-deoxyglucose positron emission tomography (FDG-PET) revealed a very small hot spot in the tail of the pancreas.
Images of the third operation. A CT scan during the third operation showing a tumor measuring 2.5 cm in diameter with cystic components in the remnant pancreatic body (arrow). B MRI after the third operation showing that the tumor had iso-intensity on a T1-weighted image and high intensity on a T2-weighted image (arrow). C FDG-PET showing a hot spot (arrow) in the body of the remnant pancreas.
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F3
In February 2011, periodic CT showed a tumor measuring 2.5 cm in diameter with cystic components in the remaining pancreatic body (Fig. 3A) but with no distant metastasis or surrounding tissue invasion. The tumor intensity on MRI was iso and high on T1- and T2-weighted images, respectively (Fig. 3B). FDG-PET showed a hot spot in the body of the pancreas (Fig. 3C).