title: [A Case of Invasive Ductal Carcinoma in the Fat Replacement of the Pancreatic Body and Tail].
abstract: A 56 year-old woman with obesity (BMI3 2) and diabetes mellitus was diagnosed with right renal cell carcinoma. She underwent right nephrectomy 1 year ago. Seven months after surgery, CT revealed a rapidly growing mass near the spleen. The mass showed slight accumulation of FDG (SUVmax=2.4) on PET-CT. Since the lesion grew rapidly and was not enhanced in the early phase of enhanced CT, we diagnosed pancreatic cancer. Distal pancreatectomy and splenectomy were performed. The final pathological diagnosis was invasive ductal carcinoma in the fat replacement of the pancreatic body and tail. Postoperatively, the patient had no complications such as pancreatic fistula or aggravation of glucose intolerance. She received postoperative chemotherapy with gemcitabine. Since she developed pulmonary artery thrombosis, postoperative chemotherapy was interrupted after 8 courses. Thirty-two months after the surgery, she was still living without any recurrence. Acinar cells were absent in the fat replacement of the pancreas, but the pancreatic duct cells were still present. There was carcinoma in situ in the main pancreatic duct surrounding chronic inflammation. Fat replacement itself could be potentially precursor of the pancreatic cancer.
authors.affiliation: Dept. of Trauma and Emergency Surgery, Sakai City Medical Center.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ebihara
authors.forename: Tameyoshi
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Hoshino
authors.forename: Jumpei
authors.initials: J
authors.lastname: Yoshimura
authors.forename: Shingo
authors.initials: S
authors.lastname: Sasamatsu
authors.forename: Yoko
authors.initials: Y
authors.lastname: Hiraki
authors.forename: Hidemi
authors.initials: H
authors.lastname: Nishi
authors.forename: Katsushu
authors.initials: K
authors.lastname: Shimizu
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kawada
authors.forename: Toshiya
authors.initials: T
authors.lastname: Inoue
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Kato
authors.forename: Koji
authors.initials: K
authors.lastname: Amano
authors.forename: Jota
authors.initials: J
authors.lastname: Mikami
authors.forename: Jun
authors.initials: J
authors.lastname: Yamamura
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Makari
authors.forename: Ken
authors.initials: K
authors.lastname: Nakata
authors.forename: Naoki
authors.initials: N
authors.lastname: Ikeda
authors.forename: Shunji
authors.initials: S
authors.lastname: Kamigaki
authors.forename: Masaki
authors.initials: M
authors.lastname: Tsujie
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kimura
authors.forename: Yasuki
authors.initials: Y
authors.lastname: Nakata
authors.forename: Satoru
authors.initials: S
authors.lastname: Munakata
authors.forename: Hiroki
authors.initials: H
authors.lastname: Ohzato
mesh_terms: D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D021441:Carcinoma, Pancreatic Ductal / Q000188:drug therapy / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D003841:Deoxycytidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D005223:Fats / Q000378:metabolism; D005260:Female; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010179:Pancreas / Q000473:pathology / Q000601:surgery*; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D013156:Splenectomy; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D005223:Fats; D003841:Deoxycytidine; D000093542:Gemcitabine