Machairas Nikolaos, Paspala Anna, Schizas Dimitrios, Ntomi Vasileia, Moris Dimitrios, Tsilimigras Diamantis I, Misiakos Evangelos P, Machairas Anastasios
Third Department of Surgery, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece.
Department of Surgery, Duke University Medical Center, Duke University, Durham, NC 27708, USA.
Mol Clin Oncol. 2019 Jan;10(1):144-146. doi: 10.3892/mco.2018.1756. Epub 2018 Nov 1.
Secondary pancreatic lesions are very uncommon. Resection of these metastatic lesions with a curative intent has been reported in selected patients; however, the survival benefit from these procedures has yet to be clearly determined. A 78-year-old male patient presented to our department with obstructive jaundice. Three years prior to presentation the patient had undergone right pneumonectomy, due to stage IIA, low-grade squamous cell lung carcinoma. After resection, the patient received adjuvant chemotherapy, with no evidence of local or systemic recurrence over the following 3 years. Abdominal computer tomography on admission revealed a 3-cm lesion located at the head of the pancreas, causing biliary obstruction. Endoscopic ultrasound biopsy revealed malignant cells, suspicious for squamous cell carcinoma. Due to the limited extent of the metastatic disease and in view of the patient's good condition, surgical resection was proposed and the patient successfully underwent pancreaticoduodenectomy. Histological examination of the resected specimen confirmed a squamous cell carcinoma, with an immunochemical profile similar to that of the primary lung tumor. Therefore, pancreatic resection with curative intent may be feasible in selected patients with secondary metastatic tumors. However, further studies are required in order to determine the benefit of these major procedures in terms of survival outcomes.
继发性胰腺病变非常罕见。在部分患者中,已有报道以治愈为目的切除这些转移性病变;然而,这些手术的生存获益尚未明确确定。一名78岁男性患者因梗阻性黄疸前来我院就诊。就诊前三年,该患者因IIA期低级别肺鳞状细胞癌接受了右肺切除术。术后,患者接受了辅助化疗,在接下来的三年里没有局部或全身复发的迹象。入院时的腹部计算机断层扫描显示胰腺头部有一个3厘米的病变,导致胆道梗阻。内镜超声活检发现恶性细胞,怀疑为鳞状细胞癌。由于转移性疾病范围有限且患者状况良好,建议进行手术切除,患者成功接受了胰十二指肠切除术。切除标本的组织学检查证实为鳞状细胞癌,免疫化学特征与原发性肺肿瘤相似。因此,对于某些继发性转移性肿瘤患者,以治愈为目的的胰腺切除术可能是可行的。然而,需要进一步研究以确定这些大型手术在生存结局方面的获益。