PANCREAS - Chronic Pancreatitis

Specimen is a subtotal pancreatectomy and spleen. The spleen is of normal size. The 3 linear incisions through the splenic capsule are to facilitate fixation. The pancreas has been sectioned longitudinally and has a nodular consistency with multiple areas of necrosis. There is associated haemorrhage into the pancreatic substance and there is also marked dilatation of the pancreatic ducts.
The patient had multiple recurrences of acute pancreatitis and underwent laparotomy for investigation of an abdominal mass. At frozen section no malignancy was found, however subtotal pancreatectomy was undertaken on the basis of recurrent pancreatitis. The patient re-presented 9 months later with a large central abdominal mass which had infiltrated the liver. This was shown to be an adenocarcinoma, the pancreas being the most likely primary site. It was therefore assumed that the tumour had arisen in the residual pancreas. The patient died of metastatic disease 12 months after pancreatectomy.