title: Metachronous multiple adenocarcinomas of the pancreas.
abstract: We report a rare case of metachronous multiple adenocarcinoma of the pancreas. A 59-year-old Japanese man visited our institute for a routine workup as a hepatitis C virus carrier, resulting in detection of a 3-cm tumor in the pancreatic body by screening echogram. Results from several imaging modalities were consistent with pancreatic carcinoma. Distal pancreatectomy along with dissection of partial gastrectomy, transverse colectomy, and lymph node dissection were performed in November 2003. Histological examination confirmed a pancreatic ductal adenocarcinoma with a clear surgical margin and negative lymph node metastases. Gemcitabine was administered for 5 years, then suspended because no recurrent signs were found. The patient returned to our hospital in March 2009, with obstructive jaundice along with a 2-cm tumor in the head of the remnant pancreas. The condition of the patient was carefully investigated and extra-pancreatic metastatic lesions were not found; a pancreaticoduodenectomy was then carried out. Histological examination revealed a diagnosis of pancreatic adenocarcinoma arising from the remnant pancreas gland.
authors.affiliation: Department of Surgery, Hamamatsu Medical Center, 328 Tomitsuka, Hamamatsu, Shizuoka 432-8580, Japan. yikemats@hmedc.or.jp
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Ikematsu
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Tamura
authors.forename: Yuuki
authors.initials: Y
authors.lastname: Nakata
authors.forename: Tadataka
authors.initials: T
authors.lastname: Hayashi
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Kanai
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Hirayama
authors.forename: Hiroki
authors.initials: H
authors.lastname: Mori
authors.forename: Takachika
authors.initials: T
authors.lastname: Ozawa
authors.forename: Shinichi
authors.initials: S
authors.lastname: Hasegawa
authors.forename: Taketoshi
authors.initials: T
authors.lastname: Okawada
authors.forename: Shinji
authors.initials: S
authors.lastname: Kageyama
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Sugimura
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Nishiwaki
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D021441:Carcinoma, Pancreatic Ductal / Q000150:complications / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D003841:Deoxycytidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D005743:Gastrectomy; D006526:Hepatitis C / Q000150:complications / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D016609:Neoplasms, Second Primary / Q000150:complications / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000150:complications / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D000093542:Gemcitabine