Pancreatic mucinous cystadenoma of borderline malignancy associated with Clonorchis sinensis

Abstract

There have been few reports on the association between clonorchiasis and pancreatic neoplasms. A case of pancreatic adenocarcinoma associated with C. sinensis has been reported [4], while cases of clonorchiasiscombined pancreatic MCN have not. In the former reports, an ultrasonogram showed marked dilatation of the intrahepatic and extrahepatic bile ducts. Biopsies of the pancreatic lesion revealed well differentiated ductal adenocarcinoma, but C. sinensis was detected in the common bile duct. Therefore, a direct association between pancreatic adenocarcinoma and C. sinensis could not be proven. However, in this case, C. sinensis was present in a mucinous cystadenoma, suggesting an association between this parasite and MCN. Although parasitic mechanical irritation and chemical injury may be involved in the pathogenesis of pancreatic mucinous cystadenoma by inducing molecular changes, similar to clonorchiasis-associated cholangiocarcinoma, we could not determine pancreatic ductal dilation and inflammatory changes, representing mechanical obstruction, and parasitic irritations. Therefore, we concluded that C. sinensis was associated with pancreatic mucinous neoplasm