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J Med Case Rep. 2017 Jul 17;11(1):194. doi: 10.1186/s13256-017-1359-3.

Resectable adenocarcinoma developing in the remnant pancreas 7 years after partial pancreatoduodenectomy for invasive ductal adenocarcinoma of the pancreas: a case report.

Author information

1
Clinic for Visceral and Thoracic Surgery, Kantonsspital Winterthur, Brauerstrasse 15, 8401, Winterthur, Switzerland. lina.frei@ksw.ch.
2
Clinic for Visceral and Thoracic Surgery, Kantonsspital Winterthur, Brauerstrasse 15, 8401, Winterthur, Switzerland.
3
Institute for Pathology, Kantonsspital Winterthur, Brauerstrasse 15, 8401, Winterthur, Switzerland.

Abstract

BACKGROUND:

Pancreatic adenocarcinoma still has an excessively high mortality rate and resection is the only potentially curative treatment. The postoperative 5-year survival rate is approximately 20% and recurrence develops generally within 2 years. We report a case of a localized recurrent pancreatic adenocarcinoma in the remnant pancreas, 7 years after initial resection.

CASE PRESENTATION:

In 2008 an abdominal computed tomography scan showed a mass in the pancreas of a 70-year-old white woman, who presented with occlusive jaundice and abdominal pain in her right upper quadrant. A pancreatoduodenectomy was performed for a clinically suspected pancreatic adenocarcinoma. Histology confirmed a ductal adenocarcinoma. Afterwards, she received adjuvant chemotherapy with gemcitabine. In 2015 a follow-up positron emission tomography-computed tomography scan showed a single lesion in her remnant pancreas. Subsequently, a partial re-resection was performed. Histology confirmed once again a ductal adenocarcinoma. She received adjuvant chemotherapy with gemcitabine again and is still alive almost 9 years after she had first been diagnosed as having pancreatic cancer.

CONCLUSIONS:

In selected cases re-resection for pancreatic recurrence is feasible and provides a survival benefit. In cases involving late recurrence, it is difficult to distinguish between true recurrence and the development of a new tumor. In order to detect recurrences at an early stage in long-term survivors, follow-up needs to occur on a regular and long-term basis.

KEYWORDS:

Long-term survivors; Recurrent pancreatic adenocarcinoma; Repeat pancreatectomy

PMID:
28716115
PMCID:
PMC5513331
DOI:
10.1186/s13256-017-1359-3
[Indexed for MEDLINE]
Free PMC Article

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