• Yoshitsugu Tajima, Tamotsu Kuroki, Noritsugu Tsuneoka, Amane Kitasato, Tomohiko Adachi, Takehiro Mishima, Taiichiro Kosaka, and Takashi Kanematsu.
• Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. ytajima@net.nagasaki-u.ac.jp
• Am. J. Surg. 2008 Nov 1; 196 (5): e50-2.

AbstractThe appropriate management for patients with multifocal branch-duct intraductal papillary mucinous neoplasms (IPMNs) of the pancreas involving the entire pancreatic gland remains unclear. We present a 66-year-old woman who underwent pylorus-preserving pancreaticoduodenectomy for a branch-duct intraductal papillary mucinous carcinoma demonstrating a grape-like multilocular cyst, 35 mm in diameter, in the head of the pancreas along with numerous number of small branch-duct IPMNs in the whole pancreas. Histologically, the multifocal cystic lesions were lined by a single row of columnar mucin-containing epithelial cells without atypia. The patient has been doing well without any recurrence during 9-year follow-up after surgery. Surgical removal of the prominent lesions suspicious of malignancy and a close observation of the remaining lesions in the remnant pancreas may be a reasonable treatment plan for patients with multifocal branch-duct IPMNs involving the entire pancreatic gland.

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