Total pancreatectomy combined with partial pancreas autotransplantation for recurrent pancreatic cancer: a case report.

Abstract

We describe a patient presenting with a resectable carcinoma of the remnant pancreas at 3 years after undergoing a pylorus-preserving pancreaticoduodenectomy for invasive ductal carcinoma of the pancreatic head. We also performed a distal pancreas autotransplantation using a part of the resected pancreas to preserve endocrine function. Final histologic findings showed the second tumor to be an invasive ductal carcinoma consisting of a well-differentiated tubular adenocarcinoma with similar histopathologic findings as the first tumor. There were no microscopic lymph node metastases and no evidence of microvascular invasion (pStage IA [pT1, pN0, M0] and R0 according to the International Union Against Cancer TNM classification). The patient was discharged at 20 days after surgery without any trouble and followed by adjuvant chemotherapy with S-1. The carbohydrate antigen 19-9 value was again normalized after the second surgery. Twenty months after the second operation, the patient is alive without cancer recurrence. The pancreas graft is functioning with a blood glucose of 108 mg/dL, HbA1C of 6.2%, and serum C-peptide of 1.4 ng/mL.

• Authors: T Kobayashi, Y Sato, H Hirukawa, M Soeno, T Shimoda, H Matsuoka, Y Kobayashi, T Tada, K Hatakeyama
• Journal: Transplantation proceedings (Transplant Proc) Vol. 44 Issue 4 Pg. 1176-9 (May 2012) ISSN: 1873-2623 [Electronic] United States
• PMID: 22564658 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2012 Elsevier Inc. All rights reserved.

Chemical References

• Blood Glucose
• C-Peptide
• CA-19-9 Antigen
• Glycated Hemoglobin A
• hemoglobin A1c protein, human

Topics

• Blood Glucose (metabolism)
• C-Peptide (blood)
• CA-19-9 Antigen (blood)
• Carcinoma, Pancreatic Ductal (diagnostic imaging, pathology, surgery)
• Female
• Glycated Hemoglobin (metabolism)
• Humans
• Middle Aged
• Neoplasm Invasiveness
• Neoplasm Recurrence, Local
• Neoplasm Staging
• Pancreas Transplantation
• Pancreatectomy
• Pancreatic Function Tests
• Pancreatic Neoplasms (diagnostic imaging, pathology, surgery)
• Pancreaticoduodenectomy
• Reoperation
• Time Factors
• Tomography, X-Ray Computed
• Transplantation, Autologous
• Treatment Outcome