Poorly differentiated ductal adenocarcinoma of the pancreas with rapid progression in a young man
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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.
KeywordsYoung Pancreatic cancer Poorly differentiated ductal adenocarcinoma Acute pancreatitis
Surveillance, epidemiology, and end results
Pancreatic ductal adenocarcinoma
Duke pancreatic monoclonal antigen type 2
Carbohydrate antigen 19-9
Main pancreatic duct
Magnetic resonance cholangiopancreatography
Endoscopic retrograde cholangiopancreatography
Endoscopic nasopancreatic drainage
Pancreatic intraepithelial neoplasia
MutL homolog 1
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
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 was obtained from all patients for being included in the study.
- 2.Howlader N, Noone AM, Krapcho M, et al, editors. SEER Cancer Statistics Review, 1975–2013. National Cancer Institute. Bethesda, MD. Based on November 2015 SEER data submission, posted to the SEER web site, 2016. http://seer.cancer.gov/csr/1975_2013/. Accessed 27 Mar 2017.