Article: PDF OnlyMucinous Ductal Ectasia of the Pancreas A Premalignant Disease and a Cause of Obstructive PancreatitisBastid, C.; Bernard, J. P.; Sarles, H.; Payan, M. J.; Sahel, J.Author Information Clinique des Maladies de l'Appareil Digestif et de la Nutrition, Hôpital Sainte Marguerite and Unité de Recherches de Pathologie Digestive U 315-46, Marseille, France Address correspondence and reprint requests to Dr. H. Sarles at INSERM U315, 46 Boulevard de la Gaye, 13009 Marseille, France. Manuscript received September 22, 1989; revised manuscript accepted January 16, 1990. Pancreas: January 1991 - Volume 6 - Issue 1 - p 15-22 Buy Abstract Five cases of localized ectasiae of pancreatic ducts associated with epithelial mucinous metaplasia have been previously reported by Itai et al. (Radiology 1986;161:697–700). During a 1-year period, we collected four new observations of patients presenting with recurrent attacks of pancreatic pain due to similar clusters of cystlike dilated ducts communicating with the main pancreatic duct and lined by a columnar epithelium interspersed with numerous goblet cells. Duct lumina were filled with mucous. Carcinoembryonic antigen levels were high in the pure pancreatic juice, but normal in the blood. Sonography and CT scan showed cystlike, intrapancreatic defects localized three times in the head of the pancreas and once in the body. Endoscopic retrograde cholangiopancreatography (ERCP) showed a huge dilation of some collateral ducts filled by radiolucent defects. The main pancreatic duct was dilated proximally to pathological ducts in three cases. Neither pancreatic stones nor exocrine insufficiency could be demonstrated 7 years after the clinical onset; one case presented with an in situ carcinoma. Since mucinous ductal ectasia is a precancerous state, surgery is mandatory. ERCP is probably the best method of diagnosis. © Lippincott-Raven Publishers.