Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
Department of Pathology, Keio University School of Medicine, Tokyo, Japan.
BMC Cancer. 2019 Apr 5;19(1):320. doi: 10.1186/s12885-019-5549-9.
Oesophageal cancer has a high metastatic potential and poor prognosis, with a significant risk of recurrence after radical resection. However, resected pancreatic metastasis from oesophageal cancer is rare.
Eleven years prior, a seventy-year-old woman had been treated with transthoracic radical oesophagectomy for oesophageal squamous cell carcinoma. Four years prior, she had undergone chemotherapy for lymph node recurrence at the splenic hilum and achieved a partial response. She had also received chemoradiotherapy for lymph node recurrence at the splenic hilum 3 years prior; a complete response was achieved. However, routine follow-up with abdominal computed tomography recently revealed a tumour at the pancreatic tail and swollen lymph nodes. The patient underwent distal pancreatectomy on the basis of a pre-operative diagnosis of primary pancreatic cancer, although a histological examination of the surgical specimen revealed metastatic squamous cell carcinoma that was compatible with metachronous pancreatic metastasis from oesophageal squamous cell carcinoma. The patient has been undergoing clinical follow-up without adjuvant therapy and has been disease-free for 24 months after resection of the pancreatic metastasis.
Resection of pancreatic metastasis may improve prognosis and should be considered when treating patients with solitary metastasis from oesophageal squamous cell carcinoma.
食管癌具有较高的转移潜能和较差的预后,根治性切除后复发风险较高。然而,从食管癌中切除的胰腺转移瘤较为罕见。
十一年前,一名 70 岁女性因食管鳞状细胞癌接受了经胸根治性食管切除术。四年前,她因脾门淋巴结复发接受了化疗,并取得了部分缓解。三年前,她还因脾门淋巴结复发接受了放化疗;取得了完全缓解。然而,最近常规腹部计算机断层扫描显示胰尾有肿瘤和肿大的淋巴结。基于术前原发性胰腺癌的诊断,患者接受了胰尾切除术,尽管手术标本的组织学检查显示转移性鳞状细胞癌,与食管鳞状细胞癌的异时性胰腺转移相符。患者在切除胰腺转移瘤后一直在接受临床随访,无辅助治疗,且无疾病复发 24 个月。
切除胰腺转移瘤可能改善预后,对于治疗食管鳞状细胞癌的单一转移患者应考虑进行该治疗。