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Multiple liver metastases of pancreatic solid pseudopapillary tumor treated with resection following chemotherapy and transcatheter arterial embolization: A case report
Authors
Fujimura Takashi
Fushida Sachio
+43 more
Hayashi Hironori
Ikeda Hiroko
Inokuchi Masafumi
Iseki Shoichi
Kinoshita Jun
Kitagawa Hirohisa
Makino Isamu
Miyashita Tomoharu
Nakagawara Hisatoshi
Nakamura Keishi
Nakanuma Shinichi
Nakayama Akira
Ninomiya Itasu
Ohta Tetsuo
Okamoto Koichi
Oyama Katsunobu
Sakai Seisho
Shoji Masatoshi
Tajima Hidehiro
Takamura Hiroyuki
Tsukada Tomoya
Wakayama Tomohiko
Watanabe Toshifumi
中川原 寿俊
中村 信一
中村 慶史
二宮 致
井口 雅史
井関 尚一
北川 裕久
太田 哲生
宮下 知治
尾山 勝信
岡本 浩一
木下 淳
林 泰寛
池田 博子
牧野 勇
田島 秀浩
若山 友彦
若山 友彦
藤村 隆
高村 博之
Publication date
1 April 2015
Publisher
'Spandidos Publications'
Doi
Cite
Abstract
金沢大学医薬保健研究域医学系A 33-year-old female was diagnosed with a solid pseudopapillary tumor (SPT) of the pancreas and multiple liver metastases at the Department of Gastroenterological Surgery, Ishikawa Prefectural Central Hospital (Kanazawa, Japan). Distal pancreatectomy and postoperative systemic chemotherapy with gemcitabine (GEM) and S-1, an oral fluoropyrimidine derivative, was administered, however, liver metastases became enlarged and local recurrence occurred. Therefore, the patient was referred to the Department of Gastroenterologic Surgery at the Graduate School of Medicine (Kanazawa, Japan) for hepatic arterial infusion (HAI) chemotherapy. Oral S-1 (80 mg/m2) was administered as well as HAI chemotherapy with GEM (1,000 mg/standard liver volume). Following 18 cycles, tumor sizes were reduced and 18-fluorodeoxyglucose positron emission tomography (18FDG-PET) examination revealed obvious reduction of tumor FDG uptake. Transarterial tumor embolization (TAE) was performed for the previously unresectable right subphrenic liver tumor, and the other tumors were surgically resected. The resected tumors were diagnosed as liver metastases and a local recurrence of SPT in the postoperative pathological examination, which revealed that the resected tumors were composed of sheets of bland cells, which were positive for CD10, CD56, vimentin, neuron-specific enolase and α-antitrypsin. The postoperative course was uneventful, and the patient is currently under observation at an outpatient clinic; postoperative adjuvant chemotherapy with oral S-1 has continued, and additional TAE is planned. In the future, if the middle segment of the liver becomes enlarged, surgery for the residual right lobe tumor may be possible. This case demonstrates one method of SPT treatment: Preoperative HAI chemotherapy with GEM, plus oral S-1 and TAE. If complete resection can be achieved, the majority of patients with SPT have a favorable prognosis. In patients with unresectable metastases from SPT, it is crucial to conduct systematic multimodal treatment to maximize treatment success. © 2015, Spandidos Publications. All Rights Reserved.Embargo Period 6 month
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Last time updated on 06/05/2019