Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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Adenosquamous Carcinoma of the Pancreas: A Case Report

낭종성 종괴로 발견된 췌체부의 원발성 선편평상피암종 1예

  • Son, Jun-Hyuk (Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Lee, Sang-Hyub (Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Cha, Byung-Hyo (Department of Internal Medicine, Cheju Halla General Hospital) ;
  • Hwang, Jin-Hyeok (Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Lee, Yun-Bin (Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Yoon, Yoo-Seok (Department of Surgery, Seoul National University Bundang Hospital) ;
  • Kim, So-Yeon (Department of Radiology, Seoul National University Bundang Hospital) ;
  • Kim, Hae-Ryoung (Department of Pathology, Seoul National University Bundang Hospital)
  • 손준혁 (분당 서울대학교병원 내과) ;
  • 이상협 (분당 서울대학교병원 내과) ;
  • 차병효 (제주한라병원 내과) ;
  • 황진혁 (분당 서울대학교병원 내과) ;
  • 이윤빈 (분당 서울대학교병원 내과) ;
  • 윤유석 (분당 서울대학교병원 외과) ;
  • 김소연 (분당 서울대학교병원 영상의학과) ;
  • 김혜령 (분당 서울대학교병원 병리과)
  • Published : 2011.06.30
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Abstract

Adenosquamous carcinoma of the pancreas is a rare tumor, which is difficult to diagnose. A 65-year-old man was admitted complaining of abdominal pain. Abdominal computed tomography (CT) demonstrated a cystic mass in the pancreatic body. Endoscopic ultrasound (EUS) showed an approximate 1.0 cm-sized hypoechoic cystic mass with a solid portion in the pancreatic body and narrowing of the main pancreatic duct. Under the impression of acute pancreatitis with a pseudocyst diagnosis, medical therapy including pancreatic stent insertion was administered to the patient for 4 weeks. A distal pancreatectomy was performed with the suspicion of pancreatic cancer due to the remaining mass on a follow-up CT scan, and the tumor was histopathologically diagnosed as stage I (TNM classification) adenosquamous carcinoma of the pancreatic body. The patient was discharged without any problems and has been on follow-up without recurrence. We report a case of adenosquamous carcinoma of the pancreas that was diagnosed relatively early with the help of EUS.

췌장의 선편평상피암종은 매우 드문 종양으로 진단이 매우 어려운 것으로 알려져 있다. 65세 남자가 복통을 주소로 내원하였다. 복부컴퓨터단층촬영 검사에서 췌체부에 낭종성 종괴가 관찰되었으며 내시경초음파 검사에서 약 1 cm 크기의 저에코를 보이며 일부 고형성분을 포함하고 주췌관의 확장을 초래하는 췌체부의 낭종성 종괴가 관찰되었다. 가성낭종을 동반한 급성췌장염 진단 하에 췌관 협착부위에 스텐트를 삽입하였고 보존적 치료를 4주간 시행하였다. 이후 추적 복부 컴퓨터단층촬영 검사에서 종괴가 여전히 남아 있는 상태로 췌장암의 가능성을 배제하기 어렵다고 판단되어 췌장 원위부 절제술을 시행하였으며 조직병리검사 결과에서 1기(TNM 분류)의 선편평상피암종으로 진단되었다. 환자는 이후 재발 없이 경과 관찰 중이다. 저자들은 내시경초음파 검사를 이용하여 비교적 이른 병기에 진단된 췌장의 선편평상피암을 경험하여 보고한다.

Keywords

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