A case of resection for lymph node recurrence around the inferior vena cava after radical surgery of undifferentiated carcinoma of the pancreatic head region

Masahiko Kubo, Daisaku Yamada, Hidetoshi Eguchi, Yoshifumi Iwagami, Takehiro Noda, Tadafumi Asaoka, Hiroshi Wada, Kouichi Kawamoto, Kunihito Gotoh, Shogo Kobayashi, Masaki Mori, Yuichiro Doki

Research output: Contribution to journalReview article

Abstract

A 60-year-old man underwent palliative surgery with a diagnosis of unresectable cancer, and he visited our hospital for further treatment. Since the cancer was unresectable and multiple hepatic tumors were revealed in CT images that were not metastases, we decided to perform curative surgery for the pancreatic cancer accompanied by partial liver invasion. Pancreaticoduodenectomy plus partial hepatectomy were performed, and 2 tumors were detected in the resected specimen: one in the pancreas-duodenum region and a submucosal tumor in the duodenum bulb. The large tumor that occupied the pancreasduodenum region was histologically diagnosed as an undifferentiated carcinoma, and the duodenal submucosal tumor was consistent with findings of a poorly differentiated adenocarcinoma. Two years after surgery, CT examination revealed a mass extending into the inferior vena cava (IVC) from near the right renal vein. We eventually diagnosed lymph node recurrence with tumor thrombosis in the IVC and started chemotherapy (FOLFIRINOX). After the tumor decreased, we performed salvage surgery involving resection of the lymph node, thrombectomy, and right nephrectomy. The tumor revealed atypical cells in the region of thrombosis, and the pathological findings were not in conflict with the findings of metastases from pancreatic cancer 2 years prior. After the treatment, chemotherapy was administered and he survived without any recurrence for 15 months after surgery.

Original languageEnglish
Pages (from-to)359-361
Number of pages3
JournalJapanese Journal of Cancer and Chemotherapy
Volume45
Issue number2
Publication statusPublished - Feb 2018

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

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    Kubo, M., Yamada, D., Eguchi, H., Iwagami, Y., Noda, T., Asaoka, T., Wada, H., Kawamoto, K., Gotoh, K., Kobayashi, S., Mori, M., & Doki, Y. (2018). A case of resection for lymph node recurrence around the inferior vena cava after radical surgery of undifferentiated carcinoma of the pancreatic head region. Japanese Journal of Cancer and Chemotherapy, 45(2), 359-361.