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A repeated pancreatectomy in the remnant pancreas 22 months after pylorus‐preserving pancreatoduodenectomy for pancreatic adenocarcinoma
Author(s) -
Wada Keita,
Takada Tadahiro,
Yasuda Hideki,
Amano Hodaka,
Yoshida Masahiro
Publication year - 2001
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/s005340170043
Subject(s) - medicine , pancreas , adenocarcinoma , pancreatectomy , papillary adenocarcinoma , splenectomy , cancer , pancreatic cancer , pylorus , radiology , gastroenterology , stomach , spleen
We report a case of a repeated curative pancreatic resection in the remnant distal pancreas 22 months after pylorus‐preserving pancreatoduodenectomy (PpPD). The patient was a 52‐year‐old woman with a past history of PpPD for adenocarcinoma of the head of the pancreas 22 months prior to the present operation. The original tumor was histopathologically diagnosed as a papillary adenocarcinoma with clear surgical margin at the surgical cut end of the pancreas (R0, International Union Against Cancer [UICC] classification). Twenty months after the PpPD, a follow‐up computed tomography (CT) scan showed multiple low‐density lesions in the body and tail of the pancreas without any other distant metastasis. A second operation, curative resection of the remnant pancreas, with splenectomy and distal gastrectomy, was performed. The second tumor was a papillary adenocarcinoma, the same diagnosis as that of the first tumor, and it also showed similar histopathological findings, including immunohistochemical staining of Ki‐67 and p53 protein, and the same pattern of K‐ ras point mutation. The patient is considered to have shown a rare, unique pancreatic cancer with metachronous carcinogenesis in the remnant pancreas.