title: Total pancreatectomy combined with partial pancreas autotransplantation for recurrent pancreatic cancer: a case report.
abstract: We describe a patient presenting with a resectable carcinoma of the remnant pancreas at 3 years after undergoing a pylorus-preserving pancreaticoduodenectomy for invasive ductal carcinoma of the pancreatic head. We also performed a distal pancreas autotransplantation using a part of the resected pancreas to preserve endocrine function. Final histologic findings showed the second tumor to be an invasive ductal carcinoma consisting of a well-differentiated tubular adenocarcinoma with similar histopathologic findings as the first tumor. There were no microscopic lymph node metastases and no evidence of microvascular invasion (pStage IA [pT1, pN0, M0] and R0 according to the International Union Against Cancer TNM classification). The patient was discharged at 20 days after surgery without any trouble and followed by adjuvant chemotherapy with S-1. The carbohydrate antigen 19-9 value was again normalized after the second surgery. Twenty months after the second operation, the patient is alive without cancer recurrence. The pancreas graft is functioning with a blood glucose of 108 mg/dL, HbA1C of 6.2%, and serum C-peptide of 1.4 ng/mL.
authors.affiliation: Department of Surgery, Tachikawa General Hospital, Nagaoka, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Y
authors.initials: Y
authors.lastname: Sato
authors.forename: H
authors.initials: H
authors.lastname: Hirukawa
authors.forename: M
authors.initials: M
authors.lastname: Soeno
authors.forename: T
authors.initials: T
authors.lastname: Shimoda
authors.forename: H
authors.initials: H
authors.lastname: Matsuoka
authors.forename: Y
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: T
authors.initials: T
authors.lastname: Tada
authors.forename: K
authors.initials: K
authors.lastname: Hatakeyama
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D002096:C-Peptide / Q000097:blood; D018395:CA-19-9 Antigen / Q000097:blood; D021441:Carcinoma, Pancreatic Ductal / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D016035:Pancreas Transplantation; D010180:Pancreatectomy; D010186:Pancreatic Function Tests; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D012086:Reoperation; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D002096:C-Peptide; D018395:CA-19-9 Antigen; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human