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Total pancreaticoduodenectomy and segmental resection of superior mesenteric vein-portal vein confluence with autologous splenic vein graft in mucinous cystadenocarcinoma of the pancreas

 Sung Hoon Choi  ;  Ho Kyoung Hwang  ;  Chang Moo Kang  ;  Woo Jung Lee 
 JOURNAL OF THE PANCREAS, Vol.11(6) : 638-641, 2010 
Journal Title
Issue Date
Cystadenocarcinoma, Mucinous/diagnostic imaging ; Cystadenocarcinoma, Mucinous/pathology ; Cystadenocarcinoma, Mucinous/surgery* ; Humans ; Male ; Mesenteric Veins/diagnostic imaging ; Mesenteric Veins/surgery* ; Middle Aged ; Pancreatic Neoplasms/diagnostic imaging ; Pancreatic Neoplasms/pathology ; Pancreatic Neoplasms/surgery* ; Pancreaticoduodenectomy/methods* ; Portal Vein/diagnostic imaging ; Portal Vein/surgery* ; Splenic Vein/transplantation* ; Tomography, X-Ray Computed ; Transplantation, Autologous
CONTEXT: Mucinous cystic tumors occur almost exclusively in middle-aged women and in the body or tail of the pancreas. Mucinous cystadenocarcinoma, a malignant sub-type of mucinous cystic tumors, in the head of the pancreas and in a middle-aged man is extraordinary, and the prognosis and proper management of mucinous cystadenocarcinoma has not been well documented.

CASE REPORT: A 52-year-old male patient with a mucinous cystadenocarcinoma approximately 5.5 cm in size in the head of the pancreas underwent a total pancreaticoduodenectomy and segmental resection of the superior mesenteric vein-portal vein confluence with an autologous splenic vein graft due to tumor invasion. His postoperative course was uneventful and he received adjuvant chemotherapy. He has been followed-up periodically for more than 30 months after surgery without evidence of recurrence.

CONCLUSION: Mucinous cystadenocarcinoma in the head of the pancreas in a middle-aged man is an extremely rare case. Because mucinous cystadenocarcinomas have a relatively good prognosis, an aggressive approach with major vascular resection is warranted in well-selected patients. Splenic vein interposition grafting could be used in cases which undergo total pancreaticoduodenectomy with segmental resection of the superior mesenteric vein-portal vein confluence if the splenic vein is healthy.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Chang Moo(강창무) ORCID logo https://orcid.org/0000-0002-5382-4658
Lee, Woo Jung(이우정) ORCID logo https://orcid.org/0000-0001-9273-261X
Choi, Sung Hoon(최성훈)
Hwang, Ho Kyoung(황호경) ORCID logo https://orcid.org/0000-0003-4064-7776
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