A Case of Early Pancreatic Microadenocarcinoma

Kang, Jin Kyung; Park, In Suh; Chung, Jae Bock; Park, Chan Il; Song, Si Young; Lee, Kee Myeong; Choi, Yoon Jung; Lee, Woo Jung

Abstract

Early pancreatic cancer is defined as the tumor size equal to or less than 2 cm, no histologic evidence of capsular invasion, abscence of lymph node, and distant metastasis. Even though there has been remarkable improvement in the diagnostic modalities for panmeatic cancer, the detection in early stages is still very difficult. Pancreatie microadenocarcinoma, which was first described in 1975 by Cubilla, is a very rare form of pancreatic adenocarcinoma. Usually the tumor is relatively large, whieh is composed of small glands, that are smaller than usual duetal adenocarcinoma in sheets or nests of relatively unifrom small cells. It resernbles a carcinoid tumor but special stainings for granules of islet or carcinoid were negative. Most cases of pancreatic mictoadenocarcinoma are diagnosed in the far advanced stage. Their mean survival rate is only 2 months, and it is seldom diagnosed in an early stage. We report a 40-year-old woman of early pancreatic microadenocarcinoma who suffered from right upper quadrant and epigastric aMominal discomfort for 1 year. AMorninal ultrasonography, computed tomography, and magnetic resononce imaging, and endoscopic ultrasonography revealed the pancreatic head mass which satisfied the criteria,for early pancreatic cancer. Pancreaticoduo- denectomy was done and immunohistochemical staining and electromnicroscopic examination of the resected specimen showed fmdings typical of the microadenocarcinoma.