[A case of pancreatic cancer with local recurrence and liver metastases eight years after surgery].

Abstract

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.

• Authors: Hajime Taniguchi, Masamichi Mizuma, Fuyuhiko Motoi, Tomoya Abe, Ryo Okada, Kei Kawaguchi, Hideaki Karasawa, Kunihiro Masuda, Shinichi Yabuuchi, Koji Fukase, Naoaki Sakata, Takaho Okada, Kei Nakagawa, Hiroki Hayashi, Takanori Morikawa, Hiroshi Yoshida, Takeshi Naito, Yu Katayose, Shinichi Egawa, Michiaki Unno
• Journal: Gan to kagaku ryoho. Cancer & chemotherapy (Gan To Kagaku Ryoho) Vol. 41 Issue 12 Pg. 2193-5 (Nov 2014) ISSN: 0385-0684 [Print] Japan
• PMID: 25731467 (Publication Type: Case Reports, English Abstract, Journal Article, Review)

Chemical References

• Antimetabolites, Antineoplastic
• Deoxycytidine
• Gemcitabine

Topics

• Adenocarcinoma (drug therapy, secondary, surgery)
• Antimetabolites, Antineoplastic (therapeutic use)
• Chemotherapy, Adjuvant
• Deoxycytidine (analogs & derivatives, therapeutic use)
• Fatal Outcome
• Female
• Humans
• Liver Neoplasms (drug therapy, secondary)
• Middle Aged
• Pancreatic Neoplasms (drug therapy, pathology, surgery)
• Pancreaticoduodenectomy
• Recurrence
• Time Factors
• Gemcitabine