Poorly differentiated ductal adenocarcinoma of the pancreas with rapid progression in a young man

  • Koji Tezuka
  • Tomoharu Ishiyama
  • Akiko Takeshita
  • Hidekazu Matsumoto
  • Akira Jingu
  • Jiro Kikuchi
  • Hideyuki Yamaya
  • Rintaro Ohe
  • Tetsuya Ishizawa
Case Report


Pancreatic cancer in young adults is very rare. We report a case of young-onset poorly differentiated pancreatic ductal adenocarcinoma with rapid progression and poor prognosis in a 31-year-old Japanese man with no obvious family history of malignancy. Preoperative examinations revealed a mass lesion in the body of the pancreas, accompanied by a slightly dilated main pancreatic duct distal to the mass lesion. Pancreatic cancer with acute pancreatitis was suspected because of an elevation of serum pancreatic enzyme and tumor marker, along with imaging findings. Distal pancreatectomy with resection of the common hepatic artery and splenectomy along with lymph node dissection was performed. Microscopically, the tumor was mainly composed of poorly differentiated ductal adenocarcinoma. The postoperative course was uneventful, but the patient had multiple liver metastases 2 months postoperatively, in spite of adjuvant chemotherapy, and died 8 months postoperatively. This case may represent a rare instance of young-onset poorly differentiated ductal adenocarcinoma with rapid progression and may indicate potential risk factors of pancreatic cancer in young adults.


Young Pancreatic cancer Poorly differentiated ductal adenocarcinoma Acute pancreatitis 



Surveillance, epidemiology, and end results


Pancreatic ductal adenocarcinoma


Computed tomography


Duke pancreatic monoclonal antigen type 2


Carcinoembryonic antigen


Carbohydrate antigen 19-9


S-pancreatic antigen-1


Glycated hemoglobin


Main pancreatic duct


Magnetic resonance cholangiopancreatography


Endoscopic ultrasonography


Endoscopic retrograde cholangiopancreatography


Endoscopic nasopancreatic drainage


Pancreatic intraepithelial neoplasia


MutL homolog 1


MutS homolog


Postmeiotic segregation increased 2


Zinc finger E-box-binding homeobox 1


Hereditary non-polyposis colon cancer


Hereditary breast and ovarian cancer syndrome


Familial atypical multiple mole melanoma


Familial adenomatous polyposis


Aldehyde dehydrogenase


Epithelial–mesenchymal transition


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Human rights and animal statements

All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed consent

Informed consent was obtained from all patients for being included in the study.


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Copyright information

© Japanese Society of Gastroenterology 2018

Authors and Affiliations

  • Koji Tezuka
    • 1
  • Tomoharu Ishiyama
    • 1
  • Akiko Takeshita
    • 2
  • Hidekazu Matsumoto
    • 1
  • Akira Jingu
    • 1
  • Jiro Kikuchi
    • 1
  • Hideyuki Yamaya
    • 1
  • Rintaro Ohe
    • 3
  • Tetsuya Ishizawa
    • 4
  1. 1.Department of SurgeryYamagata Prefectural Shinjo HospitalShinjoJapan
  2. 2.Department of SurgeryOkitama Public General HospitalKawanishiJapan
  3. 3.Department of Pathological DiagnosticsYamagata University Faculty of MedicineYamagataJapan
  4. 4.Department of GastroenterologyYamagata University Faculty of MedicineYamagataJapan

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