一例成功切除的胰腺体部癌异时性胃和胆囊转移病例。
A case of successfully resected metachronous gastric and gallbladder metastases from pancreatic body cancer.
作者信息
Takahashi Makoto, Yoshitomi Hideyuki, Kato Atsushi, Furukawa Katsunori, Takayashiki Tsukasa, Kuboki Satoshi, Takano Shigetsugu, Sugiura Kensuke, Kawasaki Keishi, Miyazaki Masaru, Ohtsuka Masayuki
机构信息
Department of General Surgery, Chiba University, Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8670, Japan.
Digestive Diseases Center, International University of Health and Welfare, Mita Hospital, Tokyo, Japan.
出版信息
Surg Case Rep. 2019 Feb 13;5(1):21. doi: 10.1186/s40792-019-0581-1.
BACKGROUND
Pancreatic ductal adenocarcinoma (PDAC) readily metastasizes to the lymph nodes, liver, lung, and peritoneum; however, gastric and gallbladder metastases are rare. We report a case of metachronous gastric and gallbladder metastases from PDAC.
CASE PRESENTATION
The patient is a 71-year-old man who underwent distal pancreatectomy for PDAC. Seventeen months after the surgery, a 30-mm nodule was detected at the lesser curvature of the stomach, which was diagnosed as recurrence of PDAC in the lymph nodes. He then received gemcitabine and S-1 combination chemotherapy for 6 months. Because tumor size remained approximately the same and tumor marker levels decreased, total gastrectomy and cholecystectomy were performed. Pathological examination showed well-differentiated tubular adenocarcinoma in the subserosa and muscularis propria of the stomach and gallbladder. The patient remains alive at 41 months after the second surgery with liver metastasis.
CONCLUSION
We reported a rare case of metachronous gastric and gallbladder metastases from pancreatic body cancer.
背景
胰腺导管腺癌（PDAC）容易转移至淋巴结、肝脏、肺和腹膜；然而，胃和胆囊转移罕见。我们报告一例胰腺导管腺癌异时性胃和胆囊转移的病例。
病例介绍
患者为一名71岁男性，因胰腺导管腺癌接受了远端胰腺切除术。术后17个月，在胃小弯处发现一个30毫米的结节，诊断为胰腺导管腺癌淋巴结复发。然后他接受了吉西他滨和S-1联合化疗6个月。由于肿瘤大小基本保持不变且肿瘤标志物水平下降，遂进行了全胃切除术和胆囊切除术。病理检查显示胃和胆囊的浆膜下层和固有肌层存在高分化管状腺癌。第二次手术后4个月，患者因肝转移仍存活。
结论
我们报告了一例罕见的胰腺体癌异时性胃和胆囊转移病例。
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