Pancreatic ductal adenocarcinoma developing from hereditary pancreatitis: A case report

Figure 1 Images obtained during the endoscopic retrograde cholangiopancreatography procedure. A: The insertion of sphincterotome into the papilla; B-D: Stone extraction balloon cleared the main pancreatic duct, with a straight-shape nasopancreatic stent left in the main pancreatic duct of the pancreatic body-tail.

Figure 2 Colonoscopy. A and B: An infiltrative lesion was observed in the sigmoid colon approximately 35 cm from the anus, with surrounding mucosa converging toward the center and exhibiting fragile texture (orange arrow).

Figure 3 Upper abdomen contrast-enhanced dynamic computed tomography and histopathological analysis of the resected specimen. A and B: Pancreatic parenchymal atrophy, multiple calcifications in the pancreatic head and body, and a non-enhancing hypodense lesion in the pancreatic tail are observed; C: Malignant tumor cells were observed in the pathological specimen of pancreatic body and tail resection combined with partial colectomy; D: Tumor cell infiltration was observed in the colon; E: A large amount of ductal adenocarcinoma was observed in the pancreas; F: Perineural invasion by carcinoma was observed in the surrounding stroma.

Figure 4 Surgical resection of gross specimens. Pancreatic tumor (white arrow) and colon (orange arrow).

Figure 5 Changes of the carbohydrate antigen 19-9 level of the patient. The preoperative carbohydrate antigen 19-9 level was pathologically elevated (989.4 U/L before surgery). Postoperatively, the carbohydrate antigen 19-9 level decreased sharply and returned to the normal range. CA19-9: Carbohydrate antigen 19-9.

Figure 6 Information from this case report organized based on a timeline. PRSS1: Serine protease 1; CP: Chronic pancreatitis; ERCP: Endoscopic retrograde cholangiopancreatography; CA19-9: Carbohydrate antigen 19-9.