Tokuhara Kaori, Okazaki Taro, Tachibana Takaaki, Ikeda Taro, Owada Yoshiyuki, Hosono Masayoshi, Ienaga Tetsuya, Kin Yasuo, Shiina Yoshitaka, Funada Yasuhiro
Dept. of Surgery, Takatsuki Hospital.
Gan To Kagaku Ryoho. 2023 Jan;50(1):90-92.
A woman in her 70s was diagnosed with cancer of pancreatic head. She underwent subtotal stomach-preserving pancreatoduodenectomy. Moderately differentiated adenocarcinoma, positive peripancreatic exfoliation surface, and R1 resection was diagnosed by histopathological examination. She underwent adjuvant chemotherapy(S-1), but 5 years and 6 months after the operation, a single nodule(16×9 mm)appeared on anterior segment of left lung. She underwent thoracoscopic left upper lobectomy on suspicion of primary lung cancer. Adenocarcinoma consistent with pancreatic cancer metastasis was diagnosed by histopathological examination. She didn't choose chemotherapy after second operation. 1 year and 1 month after the left pneumonectomy, a single nodule(11×10 mm)reappeared in lateral basal segment of right lung. Although it was difficult to diagnose whether it was primary or metastatic, she decided to undergo thoracoscopic partial lung resection. Histopathological examination revealed that the histology was similar to that of the previous lung lesion and was consistent with pancreatic cancer metastasis. After that, she also didn't choose chemotherapy. She has been alive for 7 years and 7 months after her first pancreatic cancer surgery without any new obvious recurrence.
一名70多岁的女性被诊断为胰头癌。她接受了保留胃的胰十二指肠次全切除术。组织病理学检查诊断为中分化腺癌，胰腺周围剥离面阳性，R1切除。她接受了辅助化疗（S-1），但术后5年6个月，左肺前段出现一个单个结节（16×9mm）。因怀疑原发性肺癌，她接受了胸腔镜左上叶切除术。组织病理学检查诊断为与胰腺癌转移相符的腺癌。二次手术后她未选择化疗。左肺切除术后1年1个月，右肺下叶外侧基底段再次出现一个单个结节（11×10mm）。尽管难以诊断是原发性还是转移性，但她决定接受胸腔镜部分肺切除术。组织病理学检查显示，组织学与先前的肺部病变相似，与胰腺癌转移相符。此后，她也未选择化疗。自首次胰腺癌手术后，她已存活7年7个月，无任何新的明显复发。
