Tubular adenoma of the main pancreatic duct
H. K. Shahinian, M. F. Sciadini, D. J. Springer, V. H. Reynolds and W. J. Lennington
Department of Surgery, Vanderbilt University Medical Center, Nashville, Tenn 37232.
We report a case of tubular adenoma of the duct of Wirsung with focal
villous changes. To our knowledge, this is the 13th reported case of this
uncommon neoplasm and the first with a primarily tubular histologic
pattern. The patient presented with abdominal pain and diarrhea and was
found on endoscopic retrograde cholangiopancreaticography to have a mass in
the head of the pancreas, which was confirmed by endoscopic ultrasound.
Clinical and pathological features of the 12 previously reported cases are
reviewed. Intraoperative testing failed to rule out adenocarcinoma which,
in addition to difficulties presented by local anatomic relationships of
the tumor, supports wide surgical resection as the preferred surgical
solution.
