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保留幽门的全胰切除术治疗转移性肾细胞癌:1例病例报告

Pylorus-preserving total pancreatectomy for metastatic renal cell carcinoma: a case report.

作者信息

Kitade Hiroaki, Yanagida Hidesuke, Yamada Masanori, Matsuura Takashi, Yoshioka Kazuhiko, Satoi Sohei, Matsui Yoichi, Kon Masanori

机构信息

Department of Surgery, Kansai Medical University, Takii Hospital, 10-15 Fumizono-cho, Moriguchi, Osaka, 570-8507, Japan.

Department of Surgery, Kansai Medical University, 2-5-1 Shin-machi, Hirakata, Osaka, 573-1191, Japan.

出版信息

J Med Case Rep. 2015 Sep 16;9:212. doi: 10.1186/s13256-015-0654-0.

Abstract

INTRODUCTION

Resectable isolated multiple metastases to the pancreas from renal cell carcinoma are rare. In this report, we describe a patient with multiple metastases of renal cell carcinoma to the pancreas who was treated with pylorus-preserving total pancreatectomy.

CASE PRESENTATION

The patient was a 58-year-old Asian woman who had undergone right nephrectomy for renal cell carcinoma 20 years earlier. In 2008, she was diagnosed with multiple metastases of renal cell carcinoma to the pancreas by abdominal computed tomography during routine follow-up for renal cell carcinoma. (18)F-2-fluoro-2-deoxyglucose positron emission tomography/computed tomography showed no accumulation in her body other than the pancreas. Because of concerns about her quality of life after total pancreatectomy, she underwent pylorus-preserving total pancreatectomy. After the resection, her control of blood sugar and quality of life were generally satisfactory. She died as a result of gastrointestinal bleeding 35 months after undergoing pancreatectomy.

CONCLUSIONS

Pancreatic metastasectomy should be considered, even for multiple metastases, when the primary tumor is renal cell carcinoma and the metastatic lesions are isolated.

摘要

引言

肾细胞癌可切除的孤立性胰腺多发转移瘤较为罕见。在本报告中,我们描述了一名肾细胞癌胰腺多发转移患者,其接受了保留幽门的全胰切除术治疗。

病例介绍

该患者为一名58岁的亚洲女性,20年前因肾细胞癌接受了右肾切除术。2008年,在对肾细胞癌进行常规随访期间,通过腹部计算机断层扫描诊断出她患有肾细胞癌胰腺多发转移。(18)F-2-氟-2-脱氧葡萄糖正电子发射断层扫描/计算机断层扫描显示,除胰腺外,她体内无其他部位有积聚。由于担心全胰切除术后的生活质量,她接受了保留幽门的全胰切除术。切除术后,她的血糖控制和生活质量总体令人满意。她在接受胰腺切除术后35个月因胃肠道出血死亡。

结论

当原发性肿瘤为肾细胞癌且转移灶孤立时,即使是多发转移,也应考虑行胰腺转移瘤切除术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/177e/4572449/68cff1bec200/13256_2015_654_Fig1_HTML.jpg

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