A Case of Mucin - hypersecreting Tumors of Pancreas and Bile Duct with Inflammatory Choledocho - pancreatic Fistula

Shin, Yong Woon; Lee, Myung In; Nam, Seung Woo; Roe, Im Hwan; Lee, Man Yong; Lee, Jai Hyun; Shin, Ki Chui; Kim, Jung Taik; Kim, Eo Jin

Abstract

Intraductal papillary mucinous tumor (IPMT) of the pancreas and mucin-hypersecreting bile duct tumor are characterized by intraductal papillary epithelial growth and hypersecretion of thick mucin. They show unique clinical, radiological and pathologic features. Mucin producing tumors may coexist in the bile duct and the pancreatic duct because they have the same embryologic origin. However, the case of double primary mucin producing tumors coexistent in the bile duct and the pancreatic duct is very rare in the literature. We reported a case of mucin-hypersecreting tumor of the pancreas and the bile duct with inflammatory choledocho-pancreatic fistula. The possibility of malignant invasion into the bile duct from IPMT of the pancreas was easily excluded because coexistent tumors were benign neoplasms and pancreaticobiliary fistula tract was formed by inflammation. We could not decide exactly whether the biliary intraductal lesion was a displaced pancreatic lesion or another primary biliary lesion, but benign histologic findings of both tumors suggested the likelihood of double primary neoplasms.