A 68-year-old Japanese woman presented with complaints of appetite and weight loss. Early pancreatic duct adenocarcinoma was diagnosed by endoscopic retrograde cholangiopancreatography (ERCP), which revealed partial obstruction of the main pancreatic duct. Pancreatoduodenectomy with lymph node dissection was performed. Macroscopically, no pancreatic tumor was detected. Histologically, the pancreatic lesion showed continuous changes consisting of duct epithelial cell hyperplasia, carcinoma in situ, and invasive carcinoma. Immunohistochemical stains for carcinoembryonic antigen and CA19-9 were positive in cancer cells.
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