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Case 1. Heterotopic pancreas, 1.2x1 cm Diagnosis.

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Presentation on theme: "Case 1. Heterotopic pancreas, 1.2x1 cm Diagnosis."— Presentation transcript:

1 Case 1

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6 Heterotopic pancreas, 1.2x1 cm Diagnosis

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13 Soft tissue, abdomen, US-guided biopsy: Acute and chronic inflammation Fibrosis Diagnosis

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15 Tumor location: CBD upper third just below hepatic duct bifurcation Character: Intraductal lobulation dirty hard fixed not definite mass like no definite mass on distal CBD, ampulla, duodenum Frozen: Pericystic soft tisse ->negative PeriCBD lymph node->negative Proximal CBD-> adenoca ---->1cm 위 hepatic bifurcation-> inflammation no tumor Distal CBD( curretega) negative but dysplasia+ OP findings

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34 Common bile duct, pancreas and duodenum, pancreaticoduodenectomy and bile duct resection: Adenocarcinoma, poorly differentiated 1) Location: distal common bile duct 2) Extent of the tumor: Tumor extends up to upper third of the common bile duct Tumor invades the pancreas Tumor invades the duodenal wall Tumor invades the adipose tissue surrounding the bile duct 3) Tumor size: 2.5 x 1.5 cm, distal common bile duct Involvement of bile duct with approximately 4 cm in length Diagnosis

35 4) Clear resection margins (proximal CBD: 1 cm, proximal duodenum: 5 cm, distal duodenum: 13.5 cm, distal pancreas: 3.5 cm) 5) No metastasis in 24 regional lymph nodes (0/24) (peripancreatic: 0/21, "hepatic": 0/3) 6) Lymphatic invasion: present 7) Neural invasion: present 8) Vascular invasion: not identified 9) Patholgic stage: pT3N0 Diagnosis


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