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Resectable carcinoma of the pancreatic head developing 7 years and 4 months after distal pancreatectomy for carcinoma of the pancreatic tail
Author(s) -
Eriguchi Naofumi,
Aoyagi Shigeaki,
Imayama Hiroyasu,
Okuda Koji,
Hara Masao,
Fukuda Shuichi,
Tamae Tsuyoshi,
Kanazawa Naomitsu,
Noritomi Tomoaki,
Hiraki Mamoru,
Jimi Atsuo
Publication year - 2000
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/s005340070055
Subject(s) - medicine , pancreas , adenocarcinoma , pancreatectomy , lesion , carcinoembryonic antigen , carcinoma , metastasis , distal pancreatectomy , pancreatic cancer , abdominal ultrasonography , radiology , gastroenterology , cancer , pathology , ultrasonography
A 67‐year‐old woman was referred with an abnormal finding on an abdominal echogram but presented with no symptoms; a pancreatic tail tumor was detected by ultrasonography. Biochemical examinations showed slight elevation of serum carcinoembryonic antigen level. The lesion was resected by tail and body pancreatectomy and her postoperative course was uneventful. Seven years and 4 months after the initial operation, however, her serum level of carbohydrate antigen 19‐9 was found to be elevated, and a recurrence of pancreatic cancer was suspected. Examinations revealed a mass in the head of the remnant pancreas. The lesion was radically resected by total remnant pancreatectomy. Histological examinations showed that the initial tumor was a well differentiated tubular adenocarcinoma, while the second tumor was characterized as a moderately differentiated tubular adenocarcinoma. The surgical margins of the distal pancreatectomy specimen were free of atypical cells. Therefore, the position of the second lesion diminished the likelihood that it had developed by intrapancreatic metastasis. This suggests that the second carcinoma in the head of the pancreas may have been a second primary lesion.