Studier-Fischer A, Henriques V, Rheinheimer S, Salg G A, Nickel F, Schneider M
Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany.
Department of Pathology, Heidelberg University Hospital, Heidelberg, Germany.
Int J Surg Case Rep. 2023 Apr;105:108028. doi: 10.1016/j.ijscr.2023.108028. Epub 2023 Mar 22.
Synchronous visceral malignancy is rare especially for esophagogastric junction adenocarcinoma combined with malignancy in the pancreas. So far only 7 cases of combined partial pancreatoduodenectomy and esophagectomy for synchronous malignancy have been described in the literature and none for combined total pancreatectomy and esophagectomy.
We report the case of a 67-year-old male patient, who underwent multi-modality treatment including two-stage total pancreatoduodenectomy and subsequent Ivor-Lewis esophagectomy for synchronous adenocarcinoma of the distal esophagus and pancreatic multilocal metastases of a renal cell carcinoma after nephrectomy 17 years ago. Pathology revealed R0 resections for both malignancies and there were no postoperative complications. A 12 months follow-up showed no signs of recurrence and a good quality of life.
Curative-intent, combined oncological two-stage open total pancreatoduodenectomy and esophagectomy with several days interval is safe and feasible in selected cases when performed by an experienced interdisciplinary team in a high-volume surgical center.
同步性内脏恶性肿瘤较为罕见，尤其是食管胃交界腺癌合并胰腺恶性肿瘤。迄今为止，文献中仅描述了7例因同步性恶性肿瘤而行联合部分胰十二指肠切除术和食管切除术的病例，尚无联合全胰切除术和食管切除术的相关报道。
我们报告了一例67岁男性患者的病例，该患者接受了多模式治疗，包括两阶段全胰十二指肠切除术，以及随后针对17年前肾切除术后发生的远端食管同步腺癌和胰腺多部位肾细胞癌转移灶进行的艾弗-刘易斯食管切除术。病理检查显示两种恶性肿瘤均为R0切除，且无术后并发症。12个月的随访显示无复发迹象，生活质量良好。
由经验丰富的多学科团队在大型手术中心进行的、具有治愈意图的、间隔数天的联合肿瘤学两阶段开放性全胰十二指肠切除术和食管切除术，在特定病例中是安全可行的。
