Kurihara Shigeaki, Nakazawa Kazunori, Miyamoto Hironari, Okada Takuma, Nobori Chihoko, Wang En, Hirakawa Toshiki, Aomatsu Naoki, Iwauchi Takehiko, Morimoto Junya, Yamagata Shigehito, Uchima Yasutake, Takeuchi Kazuhiro
Dept. of Surgery, Fuchu Hospital.
Gan To Kagaku Ryoho. 2019 Jan;46(1):136-138.
A67 -year-old man was diagnosed with ascending colon cancer and multiple liver metastases and underwent laparoscopic right hemicolectomy(D3 lymphadenectomy). Pathological examination indicated tubular adenocarcinoma(tub1, pT4apN2H2M1[HEP], pStage Ⅳ). After chemotherapy, he underwent hepatectomy. One year and 9 months after the first operation, obstructive jaundice appeared. Abdominal computed tomography revealed a tumor 2 cm in size in the head of the pancreas. After several detailed examinations, he was diagnosed with pancreatic metastasis of ascending colon cancer. After partial resection of the left lung metastasis, pancreaticoduodenectomy(SSPPD-Ⅱ A-1, D1 lymphadenectomy)and low anterior resection(LAR)for early rectal cancer were performed. The tumor was positive for CDX2(+), resulting in a diagnosis of pancreatic metastasis. There has been no indication of recurrence 8 months after the pancreatic surgery. Resectable pancreatic metastasis from colon cancer is rare, and there are no clear indications for resection. Some cases of long-term survival have been reported; however, further studies are needed in order to establish a consensus.
一名67岁男性被诊断为升结肠癌伴多发肝转移，接受了腹腔镜右半结肠切除术（D3淋巴结清扫）。病理检查显示为管状腺癌（tub1，pT4apN2H2M1[HEP]，p分期Ⅳ期）。化疗后，他接受了肝切除术。首次手术后1年9个月，出现梗阻性黄疸。腹部计算机断层扫描显示胰头有一个2厘米大小的肿瘤。经过多项详细检查，他被诊断为升结肠癌胰腺转移。在部分切除左肺转移灶后，进行了胰十二指肠切除术（SSPPD -ⅡA -1，D1淋巴结清扫）和早期直肠癌的低位前切除术（LAR）。肿瘤CDX2呈阳性（+），确诊为胰腺转移。胰腺手术后8个月尚无复发迹象。结肠癌可切除的胰腺转移罕见，且尚无明确的切除指征。已有一些长期生存的病例报道；然而，为达成共识还需要进一步研究。
