title: Cancer of unknown primary site in which tumor marker-oriented chemotherapy was effective and pancreatic cancer was finally confirmed at autopsy.
abstract: We report a 47-year-old man with cancer of unknown primary site in whom pancreatic cancer was confirmed at autopsy. Although a primary lesion was not confirmed, we planned to perform tumor marker-oriented chemotherapy because pancreatic cancer was suspected as the primary lesion based on tumor markers and pathological findings from metastatic lymph node. Neither S-1 nor gemcitabine was effective. However, gemcitabine combined with low-dose cisplatin therapy resulted in a marked decrease in the size of tumors. Microscopic examination at autopsy revealed poorly differentiated adenocarcinoma in the pancreatic head, although a pancreatic mass was not clear macroscopically.
authors.affiliation: Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Kanazawa, Japan. ohtsubo@kenroku.kanazawa-u.ac.jp
authors.forename: Koushiro
authors.initials: K
authors.lastname: Ohtsubo
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Watanabe
authors.forename: Tadaaki
authors.initials: T
authors.lastname: Yamada
authors.forename: Tomoya
authors.initials: T
authors.lastname: Tsuchiyama
authors.forename: Hisatsugu
authors.initials: H
authors.lastname: Mouri
authors.forename: Kaname
authors.initials: K
authors.lastname: Yamashita
authors.forename: Kazuo
authors.initials: K
authors.lastname: Yasumoto
authors.forename: Hiroko
authors.initials: H
authors.lastname: Ikeda
authors.forename: Yasuni
authors.initials: Y
authors.lastname: Nakanuma
authors.forename: Seiji
authors.initials: S
authors.lastname: Yano
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000188:drug therapy / Q000378:metabolism / Q000556:secondary; D000951:Antigens, Neoplasm / Q000378:metabolism; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D001344:Autopsy; D014408:Biomarkers, Tumor / Q000378:metabolism; D002945:Cisplatin / Q000008:administration & dosage; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000378:metabolism / Q000556:secondary; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009382:Neoplasms, Unknown Primary / Q000175:diagnosis* / Q000188:drug therapy* / Q000378:metabolism; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000188:drug therapy* / Q000378:metabolism; D000093542:Gemcitabine
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; C042317:DU-PAN-2 antigen, human; C059729:pancreatic associated antigen, SPan-1; D003841:Deoxycytidine; D002945:Cisplatin; D000093542:Gemcitabine