title: [A case of simultaneous resection of pancreatic tail and transverse hematogenous metastasis].
abstract: METHODS
  A 51-year-old male patient visited our hospital after a positive result for a stool test for occult blood. Subsequent lower gastrointestinal endoscopy showed a neoplastic lesion in the transverse colon, and abdominal computed tomography revealed a tumor in the tail of the pancreas. Since there was the possibility of multiple cancers with pancreatic cancer and transverse colon cancer, resection of pancreatic tail and transverse colectomy were performed. Histopathological findings: The pancreatic lesion was found to be a moderately differentiated tubular adenocarcinoma, and the lesion in the transverse colon was mainly located in the submucosal layer. In light of the principal lesion having the same histopathological characteristics as the pancreatic lesion, it was diagnosed as hematogenous metastasis of pancreatic cancer to transverse colon. Postoperative course: After 9 courses of 3-week administration of gemcitabine(GEM) and 1-week cessation, he developed hepatic metastasis. The treatment with GEM+S-1 was additionally repeated 7 times, but the patient was not responsive to the treatment, and died 1 year and 6 months after his first visit to our hospital.
  
  
  CONCLUSIONS
  Surgery is not generally indicated in patients with pancreatic cancer with hematogenous metastasis. In this case, a comparatively long-term survival period was achieved after simultaneous resections.
authors.affiliation: Dept. of Surgery, Shuwa General Hospital, Japan.
authors.forename: Akito
authors.initials: A
authors.lastname: Mitsuoka
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Baba
authors.forename: Shuichi
authors.initials: S
authors.lastname: Watanabe
authors.forename: Yohei
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Hironobu
authors.initials: H
authors.lastname: Baba
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nakamura
authors.forename: Takahiro
authors.initials: T
authors.lastname: Sanada
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kuwabara
authors.forename: Narihide
authors.initials: N
authors.lastname: Goseki
mesh_terms: D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D003110:Colonic Neoplasms / Q000188:drug therapy / Q000556:secondary / Q000601:surgery*; D003841:Deoxycytidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D000093542:Gemcitabine