Miyamoto Atsushi, Hama Naoki, Maeda Sakae, Hamakawa Takuya, Uemura Mamoru, Miyake Masakazu, Nishikawa Kazuhiro, Miyazaki Michihiko, Kato Takeshi, Hirao Motohiro, Sekimoto Mitsugu, Nakamori Shoji
Dept. of Surgery, National Hospital Organization Osaka National Hospital.
Gan To Kagaku Ryoho. 2019 Feb;46(2):330-332.
We report a case of recurrent pancreatic cancer in the remnant pancreas after pancreatoduodenectomy(PD)that was successfully treated by surgical resection. A woman in her 70s who was treated for multiple lung metastases of breast cancer was referred to our hospital because of obstructive jaundice. A low-density area in the pancreas head(19mm in diameter) and dilatation of the main pancreatic duct were observed on abdominal CT. She was diagnosed with pancreatic head cancer and underwent PD. Twenty months after PD, abdominal CT revealed a tumor in the pancreas tail, and she started receiving chemotherapy containing gemcitabine(GEM)for the diagnosis of recurrent pancreatic cancer in the remnant pancreas. Twelve months after the induction of chemotherapy, we performed surgical resection of the tumor(total pancreatectomy). The pathological diagnosis was moderately differentiated adenocarcinoma, which was similar to the primary lesion, and the tumor was confirmed as recurrence of pancreatic cancer. Although she died of multiple lung metastases of breast cancer 62 months after the total pancreatectomy, the recurrence of pancreatic cancer was not observed without adjuvant therapy during that time.
我们报告一例胰十二指肠切除术（PD）后残胰复发性胰腺癌经手术切除成功治疗的病例。一名70多岁因乳腺癌多发肺转移接受治疗的女性因梗阻性黄疸转诊至我院。腹部CT显示胰头有一低密度区（直径19mm）及主胰管扩张。她被诊断为胰头癌并接受了PD。PD后20个月，腹部CT显示胰尾有肿瘤，她开始接受含吉西他滨（GEM）的化疗以诊断残胰复发性胰腺癌。化疗开始12个月后，我们对肿瘤进行了手术切除（全胰切除术）。病理诊断为中分化腺癌，与原发灶相似，肿瘤被确认为胰腺癌复发。尽管她在全胰切除术后62个月死于乳腺癌多发肺转移，但在此期间未进行辅助治疗时未观察到胰腺癌复发。
