{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T13:48:10Z","timestamp":1761918490406},"reference-count":35,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2002,12,11]],"date-time":"2002-12-11T00:00:00Z","timestamp":1039564800000},"content-version":"vor","delay-in-days":40,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathology International"],"published-print":{"date-parts":[[2002,11]]},"abstract":"<jats:p>We report a rare case of minute (5\u2003mm\u2003\u00d7\u20034\u2003mm) mixed ductal\u2010endocrine carcinoma of the pancreas with predominant intraductal growth. A 34\u2010year\u2010old Japanese man was admitted because of elevated serum pancreatic enzymes. Endoscopic retrograde pancreatography revealed an unidentified material of 18\u2003mm within the main pancreatic duct. Stone or parasite with acute pancreatitis was suspected clinically, and the biopsy revealed malignant cells positive for CA19\u20109, carcinoembryonic antigen (CEA) and synaptophysin. No apparent tumor was identified in the pancreas by various imaging techniques. Resection of pancreatic body and tail was performed. Grossly, the main pancreatic duct in the pancreatic body was occluded by as much as 20\u2003mm. The pancreas had minute carcinoma of 5\u2003mm\u2003\u00d7\u20034\u2003mm just around the occluded main pancreatic duct. The tumor cells invaded the main pancreatic duct and spread within it as long as 20\u2003 mm. Histologically, the carcinoma had biphasic pattern; one was ductal carcinoma with tubular formations and another was carcinoma with neuroendocrine features. These two elements were admixed, and the ductal element comprised 30% while the endocrine element comprised 70%. The ductal element was immunoreactive for cytokeratins, CEA and CA19\u20109, while the endocrine element was immunoreactive for chromogranin A and synaptophysin. No immunoreactivity for pancreatic enzymes was noted. Ultrastructural observations showed dense core granules and no zymogen granules. Our case is unique clinically in that the tumor manifested as an intraductal material and no apparent tumor was found by imaging modalities, and pathologically in that the tumor was rare mixed ductal\u2010endocrine carcinoma and the tumor was very small and mainly grew within the main pancreatic duct.<\/jats:p>","DOI":"10.1046\/j.1440-1827.2002.01416.x","type":"journal-article","created":{"date-parts":[[2003,3,12]],"date-time":"2003-03-12T17:18:23Z","timestamp":1047489503000},"page":"740-746","source":"Crossref","is-referenced-by-count":154,"title":["Minute mixed ductal\u2010endocrine carcinoma of the pancreas with predominant intraductal growth"],"prefix":"10.1111","volume":"52","author":[{"given":"Tadashi","family":"Terada","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaharu","family":"Kawaguchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuo","family":"Furukawa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasutomo","family":"Sekido","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshiyuki","family":"Osamura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2002,12,11]]},"reference":[{"key":"e_1_2_4_2_2","doi-asserted-by":"publisher","DOI":"10.1242\/dev.121.6.1569"},{"key":"e_1_2_4_3_2","first-page":"15","volume-title":"World Health Organization: International Histological Classification of Tumours","author":"Kloppel G","year":"1996"},{"key":"e_1_2_4_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19820301)49:5<908::AID-CNCR2820490514>3.0.CO;2-J"},{"key":"e_1_2_4_5_2","first-page":"636","article-title":"A case of malignant duct\u2010islet cell tumor of the pancreas: immunohistochemical and cytofluorometric study","volume":"41","author":"Kashiwabara K","year":"1991","journal-title":"Acta Pathol. 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