内容紹介
Summary
A 71—year—old female was referred to our hospital for liver dysfunction. After careful examination, she was diagnosed with resectable pancreatic head cancer. Pancreatoduodenectomy was scheduled. In the laparotomy, 2 nodules on the liver were found. A frozen section examination of the liver nodule revealed adenocarcinoma. S—1 chemotherapy was administered for about 17 months to treat the unresectable pancreatic cancer. After chemotherapy, computed tomography(CT)revealed that the pancreatic tumor remained unchanged, and there was no distant metastasis. Positron emission tomography(PET)—CT revealed no significant uptake in the pancreatic tumor and no distant metastasis. The patient was then observed for about 10 months without chemotherapy. After that, CT showed that the size of the pancreatic tumor had increased, but there were no signs of distant metastases. Therefore, pancreatoduodenectomy was performed. Histopathological examination revealed invasive ductal adenocarcinoma in the pancreas head. The patient underwent adjuvant chemotherapy with S—1 for 5 months. So far, she has survived without any recurrence for 57 months after the initial surgery.
要旨
症例は71歳,女性。肝機能障害にて当院を紹介受診した。膵頭部腫瘤による下部胆管狭窄と胆汁細胞診陽性から膵頭部癌と診断した。開腹時,肝に2個の小結節を認め,迅速病理にて肝転移と診断した。術後S—1を開始した。CT上,膵頭部腫瘍の増大や遠隔転移を認めず,PET—CT検査にて膵頭部腫瘍への集積を認めなかったためS—1を中止し経過観察した。膵頭部腫瘍の増大を認めたが遠隔転移は認められず,初回手術2年5か月後に膵頭十二指腸切除術を施行した。初回手術後4年9か月,無再発生存中である。集学的治療により長期生存が得られた肝転移合併膵頭部癌はまれであり報告する。
目次
A 71—year—old female was referred to our hospital for liver dysfunction. After careful examination, she was diagnosed with resectable pancreatic head cancer. Pancreatoduodenectomy was scheduled. In the laparotomy, 2 nodules on the liver were found. A frozen section examination of the liver nodule revealed adenocarcinoma. S—1 chemotherapy was administered for about 17 months to treat the unresectable pancreatic cancer. After chemotherapy, computed tomography(CT)revealed that the pancreatic tumor remained unchanged, and there was no distant metastasis. Positron emission tomography(PET)—CT revealed no significant uptake in the pancreatic tumor and no distant metastasis. The patient was then observed for about 10 months without chemotherapy. After that, CT showed that the size of the pancreatic tumor had increased, but there were no signs of distant metastases. Therefore, pancreatoduodenectomy was performed. Histopathological examination revealed invasive ductal adenocarcinoma in the pancreas head. The patient underwent adjuvant chemotherapy with S—1 for 5 months. So far, she has survived without any recurrence for 57 months after the initial surgery.
要旨
症例は71歳,女性。肝機能障害にて当院を紹介受診した。膵頭部腫瘤による下部胆管狭窄と胆汁細胞診陽性から膵頭部癌と診断した。開腹時,肝に2個の小結節を認め,迅速病理にて肝転移と診断した。術後S—1を開始した。CT上,膵頭部腫瘍の増大や遠隔転移を認めず,PET—CT検査にて膵頭部腫瘍への集積を認めなかったためS—1を中止し経過観察した。膵頭部腫瘍の増大を認めたが遠隔転移は認められず,初回手術2年5か月後に膵頭十二指腸切除術を施行した。初回手術後4年9か月,無再発生存中である。集学的治療により長期生存が得られた肝転移合併膵頭部癌はまれであり報告する。