Fushimi Koya, Kusashio Kimihiko, Yasutomi Jun, Matsumoto Masanari, Suzuki Takeshi, Iida Ayako, Imamura Namiko, Harano Rina, Kosaki Ryohei, Togasaki Kentaro, Fujita Akihiro, Udagawa Ikuo
Dept. of Surgery, Chiba Rosai Hospital.
Gan To Kagaku Ryoho. 2019 Dec;46(13):2198-2200.
A 52-year-old man underwent pancreatoduodenectomy(PD)for invasive cancer of the pancreatic head, with a histopathological diagnosis of moderately to poorly differentiated invasive ductal carcinoma. One year and 2 months after PD, follow- up CT revealed a mass 3 cm in diameter in the remnant pancreas without distant metastasis. Therefore, total remnant pancreatectomy was performed with a histopathological diagnosis of adenosquamous carcinoma. Five years after re-excision, the patient remains alive without recurrence. Although no tumor component was found at the anastomotic site of the pancreatojejunostomy, squamous metaplasia with chronic inflammation with carcinogenic potential was diffusely observed in the main pancreatic duct. Clinical cases of remnant pancreatic resection after PD for invasive cancer are relatively rare. Furthermore, this case of adenosquamous carcinoma with long-term recurrence-free survival is extremely rare.
一名52岁男性因胰头浸润性癌接受了胰十二指肠切除术（PD），组织病理学诊断为中分化至低分化浸润性导管癌。PD术后1年2个月，随访CT显示残余胰腺有一个直径3 cm的肿块，无远处转移。因此，进行了全残余胰腺切除术，组织病理学诊断为腺鳞癌。再次切除术后5年，患者仍存活且无复发。尽管在胰空肠吻合口处未发现肿瘤成分，但在主胰管中广泛观察到具有致癌潜能的伴有慢性炎症的鳞状化生。PD术后因浸润性癌行残余胰腺切除术的临床病例相对较少。此外，该例腺鳞癌患者长期无复发存活极为罕见。
