Inflammatory tumor in pancreatic tail induced by endoscopic ablation with cyanoacrylate glue for gastric varices

A 65-year-old Japanese man was hospitalized with back pain in April 1998. At age 63 years, endoscopic ablation with cyanoacrylate glue had been performed for bleeding gastric varices. At the time of the present admission, a low-density mass (about 23 mm in diameter) was seen in the tail of the pancreas, and splenic vein occlusion and collateral veins were revealed on computed tomography. A hypoechoic tumor (about 22 mm in diameter) and splenic vein occlusion were clearly visualized on the pancreas tail via endoscopic ultrasonography. Venous phase of the splenic arteriogram revealed a completely occluded splenic vein in the hilus of the spleen. Thus, the patient was diagnosed with pancreatic cancer (stage I: T2N0M0). A surgical resection of the pancreatic tumor was performed, and a pancreatic tail resection with part of stomach around the pancreas tail, and splenectomy, were selected for this patient, in June 1998. Histopathological examination of the resected tumor revealed capsuled abscess formation with foreign body reaction between the stomach and the pancreas tail, and necrosis was present in the pancreas around the abscess. There were some deposits of cyanoacrylate glue in the tumor. The mass was considered to be an inflammatory tumor. In summary, this case of inflammatory pancreas tumor is a novel complication after endoscopic obliterative therapy with cyanoacrylate glue.