title: [Long-Term Survival in Response to Multimodality Therapy in a Patient with Invasive Pancreatic Cancer with Cyst Formation].
abstract: The patient was a 61-year-old man. Computed tomography(CT)in April 2007 revealed a pancreatic cyst in the tail of the pancreas. Rapid enlargement was noted in November 2007, and the patient was referred to the surgery department. CT showed a cystic lesion containing a nodular shadow in the pancreatic tail. Tumor marker measurements yielded normal carcinoembryonic antigen(CEA)and carbohydrate antigen 19-9(CA19-9)levels, but the duke pancreatic monoclonal antigen type 2(DUPAN-2)level was elevated. A diagnosis of mucinous cystic neoplasm(MCN)of the pancreas was made in December 2007, and distal pancreatectomy and partial colectomy were performed. The pathological diagnosis was a mucinous pancreatic cyst in the pancreatic tail and a moderately differentiated tubular adenocarcinoma that had invaded the spleen and serosal adipose tissue of the transverse colon. No clear ovarian-type stroma was detected, and there was no definitive evidence of MCN. The postoperative course was favorable and complication-free, and gemcitabine postoperative adjuvant therapy was administered. A metastasis was detected in the left lung in April 2011, and was excised. Chemotherapy was administered to the fifth-line, but the patient died of his cancer in August 2015, 7 years and 8 months after the initial surgery, and 4 years and 8 months after the detection of the lung metastasis. MCN and intraductal papillary mucinous neoplasm(IPMN)are typical mucus-producing pancreatic tumors, and they have a relatively good prognosis. Our patient had an invasive cancer associated with a mucinous pancreatic cyst, but no definitive diagnosis was made, and it was considered IPMN. The long-term survival appeared to have been achieved because of subsequent multimodality therapy.
authors.affiliation: Dept. of Surgery, Odawara Municipal Hospital.
authors.forename: Hironobu
authors.initials: H
authors.lastname: Makino
authors.forename: Hisashi
authors.initials: H
authors.lastname: Kametaka
authors.forename: Tadaomi
authors.initials: T
authors.lastname: Fukada
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Seike
authors.forename: Akio
authors.initials: A
authors.lastname: Hasegawa
authors.forename: Masaru
authors.initials: M
authors.lastname: Isozaki
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000601:surgery; D002288:Adenocarcinoma, Mucinous / Q000188:drug therapy / Q000601:surgery; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D003560:Cysts / Q000601:surgery; D003841:Deoxycytidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D013997:Time Factors; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D000093542:Gemcitabine