Andoh Hideaki, Kurokawa Toshiaki, Yasui Ouki, Shibata Satoshi, Sato Tsutomu
Department of Surgery, Akita University School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan.
Surg Today. 2004;34(3):272-5. doi: 10.1007/s00595-003-2680-6.
Most metastatic pancreatic tumors are detected at an advanced stage and are not considered suitable for surgery; however, resection is sometimes indicated for a solitary pancreatic metastasis from renal cell carcinoma (RCC) and improves the prognosis. We report such a case, in which the hilar liver was resected with lymph node dissection and distal pancreatectomy. Histological examination revealed regional lymph node metastasis of gallbladder carcinoma (GBC), but all the surgical margins were free of cancer. Postoperative extra-beam radiation therapy was delivered to the hepatic portal lesion to prevent GBC recurrence. The patient remains disease-free 14 months after the completion of radiation therapy. Thus, if all affected areas can be resected, the prognosis associated with pancreatic metastasis from RCC may be favorable.
大多数转移性胰腺肿瘤在晚期被发现，不被认为适合手术；然而，对于肾细胞癌（RCC）的孤立性胰腺转移瘤，有时可进行切除，这能改善预后。我们报告了这样一例病例，该病例行肝门部切除并淋巴结清扫及胰体尾切除术。组织学检查显示胆囊癌（GBC）区域淋巴结转移，但所有手术切缘均无癌残留。术后对肝门部病变进行了体外放疗以预防GBC复发。放疗结束14个月后，患者仍无疾病复发。因此，如果所有受累区域都能被切除，RCC胰腺转移的预后可能较好。
