[A case of pancreatic cancer with local recurrence and liver metastases eight years after surgery].
Here we report a rare case of late recurrence of pancreatic cancer 8 years after surgery. A woman in her mid-fifties was hospitalized for examination of epigastralgia. Computed tomography (CT) revealed a 4 cm nodule at the pancreatic head with suspected invasion of the superior mesenteric vein. She underwent pancreaticoduodenectomy with wedge resection of superior mesenteric vein and intraoperative radiation therapy. Pathological findings showed moderately differentiated tubular adenocarcinoma and T3N1M0, Stage IIB according to The Union for International Cancer Control (UICC) TNM classification. As adjuvant chemotherapy, 56 courses of gemcitabine (GEM) were administered in 3.5 years. Because of long-term use of GEM, common terminology criteria for adverse events (CTCAE) Grade 3 anemia occurred, and chemotherapy was discontinued. Tumor markers were evaluated every month and CT scans were taken every 6 months for 5 years. Subsequently, CT was performed annually. The patient was hospitalized for high-grade fever, 8.5 years after surgery. CT, magnetic resonance imaging (MRI) and positron emission tomography-computed tomography (PET-CT) detected local recurrence with liver metastases. GEM was administered again, but was ineffective. The patient died 9 years after surgery. In conclusion, even if long-term survival is achieved in pancreatic cancer, follow-ups should not be stopped.
Division of Hepato-Biliary-Pancreatic Surgery, Dept. of Surgery, Tohoku University Graduate School of Medicine.
Hajime
H
Taniguchi
Masamichi
M
Mizuma
Fuyuhiko
F
Motoi
Tomoya
T
Abe
Ryo
R
Okada
Kei
K
Kawaguchi
Hideaki
H
Karasawa
Kunihiro
K
Masuda
Shinichi
S
Yabuuchi
Koji
K
Fukase
Naoaki
N
Sakata
Takaho
T
Okada
Kei
K
Nakagawa
Hiroki
H
Hayashi
Takanori
T
Morikawa
Hiroshi
H
Yoshida
Takeshi
T
Naito
Yu
Y
Katayose
Shinichi
S
Egawa
Michiaki
M
Unno
D000230:Adenocarcinoma / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D003841:Deoxycytidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary*; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D016577:Pancreaticoduodenectomy; D012008:Recurrence; D013997:Time Factors; D000093542:Gemcitabine
D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D000093542:Gemcitabine