Miura Kotaro, Kanazawa Akishige, Shimizu Sadatoshi, Murata Akihiro, Kodai Shintaro, Nishii Takafumi, Sakurai Katsunobu, Tachimori Akiko, Tamamori Yutaka, Kubo Naoshi, Inoue Toru, Nishiguchi Yukio
Dept. of Hepato-Billiary-Pancreatic Surgery, Osaka City General Hospital.
Gan To Kagaku Ryoho. 2018 Mar;45(3):524-526.
A 70's man underwent subtotal stomach preserving pancreatoduodenectomy(SSPPD)for pancreatic head cancer. The pathological diagnosis was adenosquamous carcinoma(ASC)of the pancreas. Two months after surgery, a recurrent tumor in the remnant pancreas was confirmed with a CT scan and suspected to be ASC by endoscopic ultrasound-guided fine needle aspiration(EUS-FNA). As the recurrent lesion was limited in the pancreas, total remnant pancreatectomy(TP)was performed 4 months after SSPPD. The final pathological diagnosis was ASC. Two months after TP, liver and para-aortic lymph node metastases were revealed. The patient has been alive for 14 months after SSPPD with chemotherapy. Because of its rarity, it is difficult to implement treatment plans for recurrent ASC in the remnant pancreas.
一名70岁男性因胰头癌接受了保留胃的胰十二指肠次全切除术（SSPPD）。病理诊断为胰腺腺鳞癌（ASC）。术后两个月，CT扫描证实残余胰腺出现复发性肿瘤，经内镜超声引导下细针穿刺活检（EUS-FNA）怀疑为ASC。由于复发病变局限于胰腺，在SSPPD术后4个月进行了全残余胰腺切除术（TP）。最终病理诊断为ASC。TP术后两个月，发现肝和主动脉旁淋巴结转移。该患者在接受化疗的情况下，SSPPD术后已存活14个月。由于其罕见性，难以实施针对残余胰腺复发性ASC的治疗方案。
