Masaharu Hori

Ductectatic-type mucinous cystadenoma and cystadenocarcinoma of the human pancreas : a novel clinicopathological entity

A new type of mucinous cystic pancreatic neoplasm is described. The lesions, which have been recognized only recently with the progress of diagnostic techniques and have not previously been described in the literature, are characterized by multilocular cysts with papillary proliferation of the lining epithelium. They occur exclusively in the head and body, predominantly in males, and coexistence of well‐differentiated adenocarcinoma as well as adenoma components is frequently encountered. These lesions are quite different from hitherto described mucinous cystic neoplasms of pancreas, not only in terms of gross features but also with regard to intrapancreatic location, and sex and age distributions. We propose to classify these lesions as a new pancreatic tumor entity: the ductectatic‐type mucinous cystadenoma/cystadenocarcinoma.

Pancreatic metastasis from a lung cancer. Preoperative diagnosis and management.

SummaryA case of a surgically resectable solitary metastasis to the pancreas from a lung cancer, confirmed by immunohistochemical staining (PE-10), is reported. ERCP revealed meniscoid interruption of the main pancreatic duct, which is uncommon in patients with primary pancreatic cancers of the pancreas in our hospital. This patient lived for 29 mo after the surgical resection of the pancreatic lesion. Therefore when metastasis limited to the pancreas is evident on clinical imaging, surgical management may be more optimal than other treatment approaches.

PROGNOSIS OF PALLIATIVE RESECTION OF COLORECTAL CANCER

大腸癌は初回手術時すでに非治癒切除におわるものが, 2割前後存在し, その治療について近年積極的に切除をおこない良好な成績も報告されている. しかし非治癒因子が複数の場合予後は不良である. 癌研外科における単一非治癒因子のみをもつ非治癒切除症例の平均生存期間は, 肝転移22.2ヵ月, 腹膜播種21.6ヵ月, リンパ節転移15.2ヵ月, 局所浸潤12.3ヵ月である. 肝転移, 腹膜播種, リンパ節転移においてこれら単一非治癒因子であった場合, reductive Surgeryの効果は十分認められる. 非治癒切除病例を考える場合, 血行転移をおこしやすいもの. 腹膜播種をおこしやすいものなど, 異なる性格をもった集合体として, とらえることが重要と思われる.