内容紹介
Summary
A 63-year-old man was admitted to our hospital for examination and treatment of a pancreatic head tumor detected at a nearby hospital. After CT, EUS-FNA, and PET-CT, he was diagnosed with unresectable pancreatic cancer with liver metastasis. After 9 courses of gemcitabine and nab-paclitaxel therapy, the primary tumor was dramatically reduced in size and the liver metastasis had disappeared. He underwent subtotal stomach-preserving pancreaticoduodenectomy. The postoperative diagnosis according to the General Rules of the Study of Pancreatic Cancer(7th edition)was Ph, TS1(15 mm), adenosquamous carcinoma, ypT3, ypRP1, ypPL1, R0, ypN0(0/29), M0, CY0, ypStageⅡA. The histological response was Grade 2. The patient remains alive without recurrence 5 months after surgical resection.
要旨
症例は63歳,男性。CTにて膵頭部腫瘍を指摘され,精査加療目的に当院を紹介受診した。組織診断のためにEUS-FNAを実施しadenosquamous carcinomaの結果であった。PET-CTで肝S4とS7にFDGの異常集積を認め,遠隔転移を有する切除不能膵癌と診断し,化学療法としてgemcitabine+nab-paclitaxel療法を実施した。化学療法を9コース実施し,CTで原発巣の著明な縮小とPET-CTでの肝転移の消失を認めたため,根治切除として亜全胃温存膵頭十二指腸切除術を行った。病理所見は,Ph,TS1(15 mm),adenosquamous carcinoma,ypT3,ypRP1,ypPL1,R0,ypN0(0/29),M0,CY0,組織学的効果判定はGrade 2でypStageⅡAであった。術後5か月間再発なく経過している。
目次
A 63-year-old man was admitted to our hospital for examination and treatment of a pancreatic head tumor detected at a nearby hospital. After CT, EUS-FNA, and PET-CT, he was diagnosed with unresectable pancreatic cancer with liver metastasis. After 9 courses of gemcitabine and nab-paclitaxel therapy, the primary tumor was dramatically reduced in size and the liver metastasis had disappeared. He underwent subtotal stomach-preserving pancreaticoduodenectomy. The postoperative diagnosis according to the General Rules of the Study of Pancreatic Cancer(7th edition)was Ph, TS1(15 mm), adenosquamous carcinoma, ypT3, ypRP1, ypPL1, R0, ypN0(0/29), M0, CY0, ypStageⅡA. The histological response was Grade 2. The patient remains alive without recurrence 5 months after surgical resection.
要旨
症例は63歳,男性。CTにて膵頭部腫瘍を指摘され,精査加療目的に当院を紹介受診した。組織診断のためにEUS-FNAを実施しadenosquamous carcinomaの結果であった。PET-CTで肝S4とS7にFDGの異常集積を認め,遠隔転移を有する切除不能膵癌と診断し,化学療法としてgemcitabine+nab-paclitaxel療法を実施した。化学療法を9コース実施し,CTで原発巣の著明な縮小とPET-CTでの肝転移の消失を認めたため,根治切除として亜全胃温存膵頭十二指腸切除術を行った。病理所見は,Ph,TS1(15 mm),adenosquamous carcinoma,ypT3,ypRP1,ypPL1,R0,ypN0(0/29),M0,CY0,組織学的効果判定はGrade 2でypStageⅡAであった。術後5か月間再発なく経過している。