Blazer Dan G, Ramirez Pedro T, Wang Huamin, Fleming Jason B
Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77230-1402, USA.
JOP. 2008 Jan 8;9(1):56-60.
The majority of oncological pancreatic resections involve resection of primary pancreatic tumors. Pancreatic resection for metastatic disease is rare but can produce durable palliation or even cure in carefully selected patients. Herein, we report what to our knowledge is the first description of pancreatic resection of metastatic endometrial carcinoma.
We evaluated a patient who developed a mass in the distal pancreas as identified by screening computed tomography nearly three years after radical abdominal hysterectomy, bilateral salpingo-oophorectomy, and bilateral pelvic and para-aortic lymph node dissection for an International Federation of Gynecology and Obstetrics stage IIIA, grade 2 endometrial cancer. Findings on cytopathologic examination of tissue obtained by fine needle aspiration of the lesion were consistent with metastatic endometrial carcinoma. Radiographic imaging and physical examination failed to identify additional sites of disease. After receiving counseling as to the risks and projected benefits of surgical resection, the patient underwent a distal pancreatectomy, splenectomy, and partial gastrectomy with en bloc excision of the tumor. On final pathologic examination, all margins were free of tumor. At the time of this report, the patient remains without evidence of disease.
Metastasis to the pancreas from endometrial cancer is uncommon; however, this possibility should be considered in patients with a new pancreatic lesion and a history of endometrial cancer as pancreatic resection of metastatic disease can benefit selected patients.
大多数肿瘤性胰腺切除术涉及原发性胰腺肿瘤的切除。转移性疾病的胰腺切除术很少见，但在精心挑选的患者中可产生持久的姑息治疗甚至治愈效果。在此，我们报告据我们所知首例转移性子宫内膜癌胰腺切除术的描述。
我们评估了一名患者，该患者在因国际妇产科联盟（FIGO）III A期2级子宫内膜癌接受根治性腹式子宫切除术、双侧输卵管卵巢切除术以及双侧盆腔和腹主动脉旁淋巴结清扫术后近三年，经筛查计算机断层扫描发现胰腺远端有一个肿块。对通过病变细针穿刺获取的组织进行细胞病理学检查的结果与转移性子宫内膜癌一致。影像学检查和体格检查未发现其他疾病部位。在接受关于手术切除的风险和预期益处的咨询后，患者接受了远端胰腺切除术、脾切除术和部分胃切除术，并整块切除肿瘤。最终病理检查显示，所有切缘均无肿瘤。在撰写本报告时，该患者仍无疾病证据。
子宫内膜癌转移至胰腺并不常见；然而，对于有新的胰腺病变且有子宫内膜癌病史的患者，应考虑这种可能性，因为转移性疾病的胰腺切除术可使部分患者受益。
