Journal of Digestive Cancer Reports

Korean Society of Gastrointestinal Cancer Research (대한소화기암연구학회)
권호 표지

A Case of 47-Years-Old Female with Obstructive Jaundice and Weight Loss

  • Park, Pil Gyu (Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine) ;
  • Kang, Huapyong (Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine) ;
  • Chung, Moon Jae (Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine) ;
  • Park, Jeong Youp (Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine) ;
  • Bang, Seungmin (Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine) ;
  • Park, Seung Woo (Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine) ;
  • Song, Si Young (Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine) ;
  • Lee, Hee Seung (Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine)
  • Received : 2019.05.20
  • Accepted : 2019.06.14
  • Published : 2019.06.30

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Abstract

Serine protease inhibitor Kazal-type 1 (SPINK1) is a gene expressed from pancreatic acinar cell which its mutation is known to be associated with chronic pancreatitis (CP) and pancreatic cancer. We report a case of a 47-years-old female with nausea and weight loss with yellow discoloration of skin. Initial imaging and endoscopic study led us to an impression of chronic pancreatitis with pancreatic cancer with common bile-duct dilation. Biopsy result was confirmed with pancreatic adenocarcinoma and additional imaging revealed lymph node and bone metastasis. Our genetic analysis revealed 194+2T>C mutation of SPINK1. Biliary obstruction was successfully decompressed by stent insertion and underwent chemotherapy and radiotherapy. Although there is accumulating evidence of association between SPINK1 mutation and CP, the relationship between SPINK1 mutation and pancreatic cancer in CP patient is an emerging concept. Genetic analysis should be considered in patients with young age especially when diagnosed with both CP and pancreatic cancer.

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