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胰腺癌腹壁转移灶的潜在根治性切除:病例报告

Potentially curative resection of an abdominal wall metastasis from pancreatic adenocarcinoma: a case report.

作者信息

Odisho Tanya, Joseph Stephanie, Shahait Awni, Choi-Kim Lydia, McGee Jessica, Kim Steve

机构信息

Department of Surgery, Detroit Medical Center, Detroit, MI, USA.

The Michael and Marian Ilitch Department of Surgery, Wayne State University School of Medicine, Detroit, MI, USA.

出版信息

J Surg Case Rep. 2022 Apr 26;2022(4):rjac138. doi: 10.1093/jscr/rjac138. eCollection 2022 Apr.

Abstract

Pancreatic cancer has a low survival rate even after ostensible complete resection, and treatment for recurrence is usually only palliative. However, rare solitary metastasis can occur and may be operable. In this report, we describe such a case and review the literature on metastasectomy for pancreatic adenocarcinoma. A 66-year-old female underwent Whipple procedure at our institution in 2014 for a pT3N0 pancreatic adenocarcinoma. A slowly growing umbilical mass was noted 6 years later with concomitant rise in her CA 19-9 levels. CT-guided biopsy of her abdominal wall mass confirmed a well-differentiated adenocarcinoma consistent with her primary pancreatic cancer. The patient underwent metastasectomy of the isolated abdominal wall mass, with negative margins. She received no further postoperative treatment. The patient remains disease and symptom-free over 18 months after resection of the metastasis. In highly selected cases of pancreatic adenocarcinoma, resection of solitary metastasis may be therapeutic.

摘要

胰腺癌即便在看似完全切除后生存率仍很低,复发后的治疗通常仅为姑息性治疗。然而,罕见的孤立性转移可能发生且或许可以手术切除。在本报告中,我们描述了这样一例病例,并回顾了关于胰腺腺癌转移灶切除术的文献。一名66岁女性于2014年在我院因pT3N0胰腺腺癌接受了胰十二指肠切除术。6年后发现脐部肿物生长缓慢,同时她的CA 19-9水平升高。对其腹壁肿物进行CT引导下活检,证实为与原发性胰腺癌相符的高分化腺癌。该患者接受了孤立性腹壁肿物转移灶切除术,切缘阴性。术后未接受进一步治疗。在切除转移灶18个月后,患者仍无疾病且无症状。在经过高度挑选的胰腺腺癌病例中,孤立性转移灶的切除可能具有治疗作用。

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