Kao Chien-Ting, Aziz Muhammad, Kasi Anup
Internal Medicine/Medical Oncology, University of Kansas, Kansas City, Kansas, USA.
BMJ Case Rep. 2018 Sep 1;2018:bcr-2018-225621. doi: 10.1136/bcr-2018-225621.
The report describes a patient who presented to our centre with abdominal pain and significant weight loss due to adenocarcinoma of the tail of the pancreas. The cancer was deemed as 'resectable disease associated with morbid surgical outcomes' due to the local involvement of the vessels and adjacent organs. Given the patient's excellent performance status, the patient underwent neoadjuvant chemotherapy with folinic acid, fluorouracil, irinotecan and oxaliplatin to downstage the tumour for less morbid surgical resection. The patient underwent 12 cycles of chemotherapy with serial imaging which demonstrated positive response to treatment and surgical resection was performed. Surgical pathology revealed no residual tumour and imaging was negative for any extrapancreatic tumour metastasis. This is an unusual case as pancreatic malignancy is usually lethal with poor survival outcomes.
该报告描述了一名因胰尾腺癌出现腹痛和显著体重减轻而前来我院就诊的患者。由于肿瘤局部侵犯血管和邻近器官，该癌症被认为是“与高风险手术结局相关的可切除疾病”。鉴于患者的身体状况良好，患者接受了亚叶酸、氟尿嘧啶、伊立替康和奥沙利铂的新辅助化疗，以使肿瘤降期，从而进行风险较低的手术切除。患者接受了12个周期的化疗，并进行了系列影像学检查，结果显示对治疗有阳性反应，随后进行了手术切除。手术病理显示无残留肿瘤，且影像学检查未发现任何胰腺外肿瘤转移。这是一个不寻常的病例，因为胰腺恶性肿瘤通常是致命的，生存结局较差。
