胰腺腺泡细胞癌患者的长期生存。病例报告及文献复习。
Long-term survival in a patient with acinar cell carcinoma of pancreas. A case report and review of literature.
作者信息
Antoine Monique, Khitrik-Palchuk Marina, Saif Muhammad Wasif
机构信息
Yale Cancer Center, Yale University School of Medicine, New Haven, CT 06520, USA.
出版信息
JOP. 2007 Nov 9;8(6):783-9.
CONTEXT
Acinar cell carcinoma of the pancreas is a rare malignancy that may have acinar and endocrine differentiation. Clinical practice guidelines exist for pancreatic ductal adenocarcinoma. However, treatment protocols for acinar cell carcinoma of the pancreas have not been standardized.
CASE REPORT
We describe a case of a 44-year-old woman presenting with low grade fever and mid-abdominal tenderness secondary to a pancreatic mass with acinar and endocrine differentiation metastatic to the liver. The patient received multiple lines of conventional and investigational chemotherapy regimens. This included cycles of gemcitabine, irinotecan, oxaliplatin, docetaxel, capecitabine, octreotide, leucovorin, 5-fluorouracil, cisplatin, protein kinase C inhibitor, tyrosine kinase inhibitor, and a novel taxane. The patient developed Clostridium difficile colitis and septic shock resulting in death 37 months after the diagnosis of acinar cell carcinoma of the pancreas.
CONCLUSION
This is a case of acinar cell carcinoma of the pancreas with an endocrine component, treated with multiple chemotherapeutic agents, in which the patient survived 37 months after diagnosis.
背景
胰腺腺泡细胞癌是一种罕见的恶性肿瘤,可能具有腺泡和内分泌分化。目前已有胰腺导管腺癌的临床实践指南。然而,胰腺腺泡细胞癌的治疗方案尚未标准化。
病例报告
我们描述了一例44岁女性患者,因胰腺肿块伴腺泡和内分泌分化并转移至肝脏,出现低热和中腹部压痛。该患者接受了多线传统和试验性化疗方案。这包括吉西他滨、伊立替康、奥沙利铂、多西他赛、卡培他滨、奥曲肽、亚叶酸钙、5-氟尿嘧啶、顺铂、蛋白激酶C抑制剂、酪氨酸激酶抑制剂和一种新型紫杉烷的周期治疗。该患者发生艰难梭菌结肠炎和感染性休克,在胰腺腺泡细胞癌诊断37个月后死亡。
结论
这是一例伴有内分泌成分的胰腺腺泡细胞癌病例,接受了多种化疗药物治疗,患者在诊断后存活了37个月。