Obed Aiman, Siyam Mahmoud, Jarrad Amr Anwar, Abdelhadi Ody, Ababneh Muaweih, Annab Hassan, Füzesi Laszlo, Bashir Abdalla, Jarrad Anwar
Hepatobiliary and Transplant Surgery, Jordan Hospital, Amman, Jordan.
General Surgery, Jordan Hospital, Amman, Jordan.
J Surg Case Rep. 2023 Jan 10;2023(1):rjac638. doi: 10.1093/jscr/rjac638. eCollection 2023 Jan.
We report the case of a 56-year-old male with pancreatic cancer and 25 liver metastases. The patient underwent a distal pancreatectomy with 11 metastasectomies in the left liver lobe. Histological examination demonstrated a moderately differentiated ductal adenocarcinoma with pT3N0M1, Stage IVb. Three weeks later, we performed transarterial chemoembolization for the right lobe of the liver, and after 6 weeks we started systemic chemotherapy with FOLFIRINOX. After 31 months, computer tomography examination showed increases in size of the remaining lesions at segment VII/VIII of the right lobe. All liver metastases were surgically removed and a new chemotherapy was initiated. Nevertheless, after 40 months the patient developed two brain metastases. One was surgically resected and the smaller lesion was treated by gamma knife. Unfortunately, the patient died 42 months after the first presentation. Conclusively, in very selected patients with synchronic liver metastasis, multimodal treatment including repeated surgery, TACE and chemotherapy may prolong survival.
我们报告了一例56岁男性胰腺癌患者，伴有25处肝转移。该患者接受了远端胰腺切除术，并对左肝叶的11处转移灶进行了切除。组织学检查显示为中度分化的导管腺癌，pT3N0M1，IVb期。三周后，我们对肝右叶进行了经动脉化疗栓塞，6周后开始使用FOLFIRINOX进行全身化疗。31个月后，计算机断层扫描检查显示右叶VII/VIII段剩余病灶增大。所有肝转移灶均通过手术切除，并开始新的化疗。然而，40个月后患者出现两处脑转移。一处通过手术切除，较小的病灶通过伽马刀治疗。不幸的是，患者在首次就诊后42个月死亡。总之，对于极少数同时性肝转移患者，包括重复手术、经动脉化疗栓塞和化疗在内的多模式治疗可能会延长生存期。
