Coexistence of mucinous cystic neoplasm occurring in the head of the pancreas with annular pancreas: Report of a case

Abstract

Mucinous cystic neoplasms (MCN) of the pancreas are rare tumors that are almost exclusively located in the body or the tail of the pancreas. A 60-year-old woman with no history of pancreatic disease was referred to our hospital with a chief complaint of dull pain in the upper abdomen. Abdominal computed tomography showed a multilocular cystic mass of 7.0 cm in the head of the pancreas, and endoscopic retrograde cholangiopancreatography showed no communication between the cystic mass and the main pancreatic duct. A pancreatoduodenectomy was performed for the complete resection of the tumor, and an annular pancreas was discovered by accident. The pathological examination of the tumor led to a definitive diagnosis of MCN with ovarian-type stroma. To our knowledge this is the first documented case of MCN occurring in the head of the pancreas and associated with annular pancreas.

An annular pancreas associated with carcinoma of the papilla of Vater: report of a case

“…In the surgical cases of annular pancreas reviewed by Yogi et al [14], 9 (8.5%) of the 106 cases displayed a pancreaticobiliary malignancy (5 ampullary carcinomas, 2 pancreatic carcinomas, and 2 cholangiocarcinomas). Among the cases reported in the English literature, the most common pancreaticobiliary neoplasia associated with an annular pancreas was ampullary carcinoma (6 cases) ( Table 1) [15][16][17][18][19], followed by pancreatic carcinoma (5 cases) [20][21][22][23][24], cholangiocarcinoma (2 cases) [12,25], insulinoma (1 case) [26], and mucinous cystic neoplasm (MCN) (1 case) [27]. The chronic obstruction caused by an annular pancreas has been postulated to prompt continuous exfoliation of cells in the region of the ampulla and rapid mucosal turnover, facilitating dysplastic changes and metaplasia in that region [17].…”