Fat replacement of the distal pancreas in a case of advanced gastric cancer.
Preoperative computed tomography in a 67-year-old man admitted with type 2 advanced gastric cancer involving the upper body of the stomach revealed marked atrophy of the left lobe of the liver and atrophy of the distal pancreas. Total gastrectomy with D2 lymph node dissection was planned; however, additional distal pancreatectomy with splenectomy was also performed during the operation because of direct invasion of the pancreas by the gastric cancer. Histopathologic examination of the resected pancreas revealed the absence of lobules, acini, conduits, and pancreatic ducts, with only islets of Langerhans found scattered in the adipose tissue. The findings revealed that the gastric cancer had directly invaded the fat, replacing the distal pancreas. In patients with fat-replaced pancreas, preoperative evaluation of direct invasion of adjacent organs/tissues by gastric cancer is difficult.
Department of Surgery, Kanto Medical Center NTT EC, Tokyo, Japan. takeshita.nobuyoshi@east.ntt.co.jp
Nobuyoshi
N
Takeshita
Tamaki
T
Noie
Yuichi
Y
Otsuka
Akihiro
A
Hoshino
Satoshi
S
Nara
Kei
K
Ito
Yasushi
Y
Harihara
Kaoru
K
Furushima
Toshiro
T
Konishi
D000273:Adipose Tissue / Q000473:pathology*; D000368:Aged; D001284:Atrophy; D016099:Endoscopy, Gastrointestinal; D005743:Gastrectomy; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D009361:Neoplasm Invasiveness; D010179:Pancreas / Q000473:pathology*; D010180:Pancreatectomy; D013156:Splenectomy; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery; D014057:Tomography, X-Ray Computed