Sumiyoshi Tatsuaki, Shima Yasuo, Okabayashi Takehiro, Kozuki Akihito, Iwata Jun, Saisaka Yuichi, Tokumaru Teppei, Nakamura Toshio, Morita Sojiro
From the Department of Gastroenterological Surgery (TS, YS, TO, AK, YS, TT, TN); Department of Diagnostic Pathology (JI); and Department of Radiology (SM), Kochi Health Sciences Center, Kochi, Japan.
Medicine (Baltimore). 2015 Jan;94(1):e378. doi: 10.1097/MD.0000000000000378.
Current case is the third report of S-1 chemotherapy against acinar cell carcinoma (ACC) of pancreas, and our patient has achieved the longest reported recurrence-free survival, longer than 6 years, despite the presence of disseminated nodules at laparotomy.A 77-year-old man presented with abdominal discomfort. Computed tomography showed a low-density tumor in the pancreas tail and the patient was referred for surgery. A 3-cm sized pancreatic tumor, with localized disseminated nodules, was detected on laparotomy. Distal pancreatectomy with concomitant resection of disseminated nodules was performed, and histopathological examination revealed an ACC. Oral S-1 chemotherapy was administered postsurgery, and the patient showed no sign of recurrence during 73 months of follow-up. This is the first report of long-term survivor of pancreatic ACC with peritoneal dissemination, following pancreatectomy and S-1 chemotherapy.Current case suggests a beneficial effect of S-1 chemotherapy in cases of ACC.
目前的病例是关于S-1化疗治疗胰腺腺泡细胞癌（ACC）的第三例报告，尽管我们的患者在剖腹手术时存在播散性结节，但仍实现了最长的无复发生存期，超过6年。一名77岁男性因腹部不适就诊。计算机断层扫描显示胰尾有一个低密度肿瘤，患者被转诊接受手术。剖腹手术时发现一个3厘米大小的胰腺肿瘤，伴有局部播散性结节。进行了远端胰腺切除术并同时切除播散性结节，组织病理学检查显示为ACC。术后给予口服S-1化疗，患者在73个月的随访期间未出现复发迹象。这是第一例关于胰腺ACC伴腹膜播散、行胰腺切除术后接受S-1化疗的长期存活者的报告。目前的病例表明S-1化疗对ACC病例有有益作用。
