Reoperation for heterochronic intraductal papillary mucinous neoplasm of the pancreas after bile duct neoplasm resection: A case report

Figure 1 Immunohistochemical examination of the resected specimen. A-D: Immunohistochemical staining for Muc-1 (A), Muc-2 (B), Muc-5AC (C), and Muc-6 (D), × 200.

Figure 2 Positron emission tomography showed a mass in the head of the pancreas. Maximum standard uptake value: 11.8.

Figure 3 Preoperative imaging findings for the initial surgery. A: Magnetic resonance cholangiopancreatography showed a left hepatobiliary mass with dilatation of the upstream bile duct; B: Magnetic resonance cholangiopancreatography indicated pancreaticobiliary maljunction (indicated by arrow). The junction of the pancreatic and the bile duct was outside the duodenal wall with a long common channel.

Figure 4 Gross specimens showed pancreaticobiliary maljunction (indicated by arrow). The pancreatic duct and bile duct shared a long common channel. The intraductal papillary mucinous neoplasm was located in the neck of the pancreas.