Papillary-cystic neoplasm of the pancreas with multiple hepatic metastases: A case report

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Abstract
We report a case of papillary-cystic neoplasm (PCN) of the pancreas in a 42-yr-old woman. Because of complication with multiple hepatic metastases, the patient could not receive radical operation, and was treated palliatively. The right hepatic tumors decreased in volume by an average of 28% (range: 13–54%) following intra-arterial infusion of doxorubicin and gelatine sponge—i.e. chemoembolization therapy. On the other hand, the left lobe tumor increased by 15% in volume following intra-arterial infusion of doxorubicin alone without selective embolization. A subsequent systemic combination chemotherapy (combinations of 5-fluorouracil, doxorubicin and mitomycin-C) was less effective for both the primary and metastatic sites of PCN of the pancreas. Intra-arterial chemoembolization proved useful—as expected—as a palliative measure. Papillary-cystic neoplasm of the pancreas accompanied by hepatic metastasis is very rare. We present herein its clinical behavior and response to the above treatment as documented by CT scan.