Successful pre-operative diagnosis of malignant intraductal papillary mucinous tumor of the pancreas by detecting telomerase activity.

摘要

BACKGROUND: Pre-operative differential diagnosis between benign and malignant intraductal papillary mucinous tumor (IPMT) of the pancreas is markedly difficult by imaging examination. In recent years, telomerase activity has been reported to be detected only in malignant tumors. METHODS: A 52-yr-old man with abdominal pain was diagnosed with a IPMT through imaging examination. Telomerase activity of the pure pancreatic juice, which was obtained pre-operatively by endoscopic retrograde pancreatic juice aspiration (ERPJA), was analyzed by telomeric repeat amplification protocol (TRAP) assay. RESULTS: Telomerase activity was detected in the pure pancreatic juice of the patient, who was diagnosed with a malignant IPMT. A pylorus-preserving pancreatoduodenectomy was performed, and subsequent pathological findings revealed the tumor to be adenocarcinoma in adenoma with papillary growth. CONCLUSION: Detection of telomerase activity of the pure pancreatic juice might be useful to distinguish benign from malignant IPMT pre-operatively.