Hamasaki Taro, Tokumitsu Yukio, Shindo Yoshitaro, Matsui Hiroto, Matsukuma Satoshi, Nakajima Masao, Tomochika Shinobu, Yoshida Shin, Iida Michihisa, Suzuki Nobuaki, Takeda Shigeru, Yoshino Shigefumi, Hazama Shoichi, Ueno Tomio, Nagano Hiroaki
Dept. of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine.
Gan To Kagaku Ryoho. 2019 Dec;46(13):2428-2430.
The patient was a 17-year-old woman. An abnormal urinalysis was observed, and abdominal echography showed a pancreatic cystic mass. At the first examination, computed tomography(CT)and endoscopic ultrasound(EUS)showed a unilocular cystic mass of 60mm in size in the pancreatic body and tail, and no malignant findings were observed. After 14 months, CT and positron emission tomography-computed tomography(PET-CT)showed that the cystic mass had a mural nodule with FDG accumulation, and presence of a tumor in hepatic S8 with FDG accumulation. Laparoscopic distal pancreatectomy and hepatic subsegmentectomy of S8 were performed for diagnostic and therapeutic purposes. The pathological diagnosis was mucinous cystadenocarcinoma(MCC)and metastatic liver cancer in the form of MCC. S-1 was administered after surgery. Nine months after resection, multiple metastatic liver tumors were found, and GEM plus nab-PTX was administered. After 2 courses of treatment, the patient is still alive without new lesions.
患者为一名17岁女性。尿液分析结果异常，腹部超声检查显示胰腺有一个囊性肿块。初次检查时，计算机断层扫描（CT）和内镜超声（EUS）显示胰体和胰尾有一个大小为60mm的单房囊性肿块，未观察到恶性征象。14个月后，CT和正电子发射断层扫描-计算机断层扫描（PET-CT）显示囊性肿块有一个壁结节伴氟代脱氧葡萄糖（FDG）积聚，且肝S8区有一个伴FDG积聚的肿瘤。为明确诊断并进行治疗，实施了腹腔镜下远端胰腺切除术和肝S8亚段切除术。病理诊断为黏液性囊腺癌（MCC）及以MCC形式出现的肝转移癌。术后给予替吉奥（S-1）治疗。切除术后9个月，发现多处肝转移瘤，遂给予吉西他滨（GEM）联合纳米白蛋白结合型紫杉醇（nab-PTX）治疗。经过2个疗程的治疗后，患者仍存活，未出现新的病灶。
