There have been an increasing number of reports of intraductal papillary mucinous neoplasms (IPMNs) of the pancreas since its first report by Ohhasi et al. in 1982. Most IPMNs arise from Wirsung's duct or its branches, whereas IPMNs arising from Santorini's duct are rare. Pancreas divisum is a common congenital anatomical anomaly characterized by the lack of fusion of the ventral and dorsal parts of the pancreas during the eighth week of fetal development. Although clinical significance of pancreas divisum has been the subject of debate for many years, there seems to be little doubt that in certain patients there is a causal relation between pancreas divisum and pancreatitis. Also, it is occasionally accompanied by a pancreatic tumor. Herein, we report a case of IPMN arising from Santorini's duct in patient with complete type of pancreas divisum.
Adenocarcinoma, Mucinous/*diagnosis/etiology ; Aged ; Carcinoma, Pancreatic Ductal/*diagnosis/etiology ; Carcinoma, Papillary/*diagnosis/etiology ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangiopancreatography, Magnetic Resonance ; Diagnosis, Differential ; Female ; Humans ; Pancreatic Ducts/abnormalities/*surgery ; Pancreatic Neoplasms/*diagnosis/etiology

Mucinous (colloid) carcinoma is defined as pools of stromal extracellular mucin containing scanty, floating carcinoma cells. It is a well-defined entity in breast or large bowel. However, mucinous noncystic carcinoma of the pancreas (MNCC) is uncommon, comprising between 1% and 3% of all carcinomas of the pancreas. In the past, MNCC generally had been categorized together with ordinary ductal adenocarcinoma or misdiagnosed as mucinous cystadenocarcinoma or signet-ring cell carcinoma. The new WHO classification lists MNCC as a variant of ductal adenocarcinoma. Herein, we report a 32-year-old woman with incidentally found pancreatic body mass who underwent subtotal pancreatectomy. She was diagnosed as MNCC histologically.
Adenocarcinoma, Mucinous/*diagnosis/etiology/pathology ; Adult ; Breast Neoplasms/diagnosis ; Carcinoma, Pancreatic Ductal/*diagnosis/pathology ; Diagnosis, Differential ; Female ; Humans ; Pancreatic Neoplasms/*diagnosis/pathology ; Tomography, X-Ray Computed

Pancreatic cancer is currently the major leading cause of cancer-related deaths in the Western countries with an overall 5-year survival rate of less than 3. The key aim of investigation is to identify the cellular population in which some of the earliest molecular events occur, presumably the ultimate target for carcinogenic insult. Advances in pathological classification and genetics have improved our descriptive understanding of this disease. However, important aspects of pancreatic cancer biology remain poorly understood. Factors associated with the increased risk of pancreatic cancer include smoking, chronic pancreatitis, diabetes, prior gastric surgery, and exposure to radiation or chemicals. A number of syndromes have been identified with the increased incidence of pancreatic cancer, including familial atypical multiple-mole melanoma syndrome, hereditary nonpolyposis colorectal cancer, and hereditary pancreatitis, etc. Recently, there have been growing evidences that stem cell biology could provide new insights into the understanding of cancer biology. Three postulates regarding the relationship between stem and tumor cells have been proposed. First, the similarities in the mechanims that regulate self-renewal of normal stem cells and cancer cells. Second, the possibility that tumor cells might arise from normal stem cells and third, the notion that tumors might contain 'cancer stem cells' - rare cells with indefinite proliferative potential which drive the formation and growth of tumors. New insights for the cancer stem cells and their possible markers in pancreatic cancer have been suggested recently. Further observations of molecular and cellular events in the early stage of pancreatic carcinogenesis may have important implications regarding the cellular lineage responsible for pancreatic ductal metaplasia and neoplasia, and provide further support for the presence of stem cell capabilities within mature pancreatic epithelium.
Carcinoma, Pancreatic Ductal/*etiology/genetics/pathology ; Disease Progression ; Humans ; Mutation ; Neoplasm Proteins/genetics ; Neoplastic Syndromes, Hereditary/genetics ; Oncogenes ; Pancreatic Neoplasms/diagnosis/*etiology/genetics ; Risk Factors ; Tumor Markers, Biological