Mashiko Taro, Nakano Akira, Masuoka Yoshihito, Yamamoto Seiichiro, Ozawa Soji, Nakagohri Toshio
Dept. of Gastroenterological Surgery, Tokai University School of Medicine.
Gan To Kagaku Ryoho. 2020 Aug;47(8):1233-1235.
A 64-year-old man visited our hospital because of weight loss and after being detected with a tumor in the pancreatic body and tail on abdominal ultrasonography at a nearby hospital. Abdominal contrast-enhanced CT revealed a 45 mm tumor with celiac artery invasion in the pancreatic body and tail. This case was diagnosed as unresectable pancreatic cancer. After 2 regimens of systemic chemotherapy(5 courses of gemcitabine plus nab-paclitaxel and 2 courses of S-1), CT revealed a partial response(ie, reduction in the tumor size). Therefore, distal pancreatectomy was performed with en bloc celiac axis resection, portal vein resection, and left adrenalectomy, as well as lymph node dissection. The pathological diagnosis was adenosquamous carcinoma, and R0 resection was achieved. The histological response was Grade 1b. However, the patient developed lung metastasis 16 months after surgery and liver metastasis 18 months after surgery; he died 33 months after starting treatment.
一名64岁男性因体重减轻前来我院就诊，其在附近医院进行腹部超声检查时发现胰体尾部有肿瘤。腹部增强CT显示胰体尾部有一个45毫米的肿瘤，侵犯腹腔干动脉。该病例被诊断为不可切除的胰腺癌。经过2个周期的全身化疗（吉西他滨联合纳米白蛋白紫杉醇5个疗程和S-1 2个疗程）后，CT显示部分缓解（即肿瘤大小缩小）。因此，进行了胰体尾切除术，同时整块切除腹腔干、门静脉和左肾上腺，并进行了淋巴结清扫。病理诊断为腺鳞癌，实现了R0切除。组织学反应为1b级。然而，患者术后16个月出现肺转移，术后18个月出现肝转移；开始治疗33个月后死亡。
