[A case report of port-site metastasis of pancreatic cancer after laparoscope assistted distal pancreatectomy].
Laparosopic port-site metastasis is rare, but a well recognized outcome following surgery in gastroenterological surgery for gastric cancer, colon cancer and gallbladder cancer with its etiology was not clearly understood. We report a port-site metastasis of pancreatic cancer diagnosed by position emission tomography( PET). A 49-year-old man was diagnosed as splenic tumor with pancreatic tail invasion due to malignant lymphoma, and received a laparoscope assisted distal pancreatectomy. Unsuspected pancreatic cancer was discovered with histological result of moderate differentiated invasive ductal adenocarcinoma of the pancreas infiltrating spleen. Systemic chemotherapy with 1,000 mg/m² of gemcitabine (GEM) was performed for six months. Unfortunately, our patients relapsed one year after the surgery with multiple lesions in the peritoneum, abdominal wall, as well as a laparoscopic port-site metastasis. He was started on 100 mg/body of S-1 daily, subsequently, combined chemotherapy with GEM( 80 mg/m²) and S-1( 80 mg/body) was also performed. Furthermore, he underwent palliative radiation therapy( 40 Gy) to care the pain. Fortunately, a long-term survival of 3 years was elicited by these systemic treatments and radiography. Laparoscopic port-site metastases are associated with presence of advanced cancer. Therefore, we should carefully precede a laparoscopic resection against pancreatic cancer.
Dept. of Gastroenterological Surgery, Osaka University Graduate School of Medcine.
Chikato
C
Koga
Masahiro
M
Tanemura
Hiroshi
H
Wada
Shogo
S
Kobayashi
Shigeru
S
Marubashi
Hidetoshi
H
Eguchi
Masaki
M
Mori
Yuichiro
Y
Doki
Hiroaki
H
Nagano
D034861:Abdominal Wall / Q000473:pathology; D044584:Carcinoma, Ductal / Q000473:pathology* / Q000601:surgery* / Q000628:therapy; D003131:Combined Modality Therapy; D006801:Humans; D020706:Laparoscopes / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000473:pathology* / Q000601:surgery* / Q000628:therapy; D010534:Peritoneal Neoplasms / Q000556:secondary* / Q000628:therapy