[A case of peritoneal recurrence of invasive carcinoma derived from IPMN after distal pancreatectomy].
The patient was a 62-year-old man who underwent distal pancreatectomy and partial resection of transverse colon with diagnosis of cystic tumor of pancreas tail in July 2006. In histology, the tumor was an invasive carcinoma derived from intraductal tumor. So, Chemotherapy using gemcitabine (GEM) was administered. Eleven months after the operation, abdominal contrast-enhanced CT showed a cystic tumor in the subdiaphragm and CEA increased to 15 .2 ng/mL. Combination chemotherapy using GEM and S-1 was administered under the diagnosis of peritoneal recurrence. CEA decreased to a normal level, but 19 months after the operation, CA19-9 increased to 187 .7 U/mL. Then, radiotherapy (a total of 40 Gy) was performed. Twenty two months after the radiotherapy, though chemotherapy using S-1 was continued, CA19-9 re- increased to 134 .2 U/mL. Abdominal contrast-enhanced CT and PET detected no other recurrent lesion. A tumor resection was performed in January 2010. In immunostaining MUC1(+), MUC2(-), MUC5AC(+), MUC6(+) and mucus expression forms as well as with previous specimen, and was diagnosed as recurrence of the invasive carcinoma derived from intraductal tumor.
Dept. of Surgery, Dept. of Medicine, Kurume University School of Medicine.
Yuhei
Y
Kitasato
Masafumi
M
Yasunaga
Masamichi
M
Nakayama
Gen
G
Akasu
Munehiro
M
Yoshitomi
Kazuhiro
K
Mikagi
Ryuichi
R
Kawahara
Hiroto
H
Ishikawa
Toru
T
Hisaka
Hiroyuki
H
Horiuchi
Hisafumi
H
Kinoshita
Yoshinobu
Y
Okabe
D000970:Antineoplastic Agents / Q000627:therapeutic use; D021441:Carcinoma, Pancreatic Ductal / Q000473:pathology / Q000628:therapy*; D059248:Chemoradiotherapy; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D004338:Drug Combinations; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010094:Oxonic Acid / Q000008:administration & dosage / Q000627:therapeutic use; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000628:therapy*; D010534:Peritoneal Neoplasms / Q000556:secondary / Q000628:therapy*; D012008:Recurrence; D005641:Tegafur / Q000008:administration & dosage / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D000093542:Gemcitabine
D000970:Antineoplastic Agents; D004338:Drug Combinations; D003841:Deoxycytidine; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D000093542:Gemcitabine