A Case of Ascending Colon Cancer with Metacronous Pancreas Metastasis Resected by Pancreatico Duodenectomy After Chemo-Radiation Therapy

Abstract

We report a case that received a pancreatico-duodenectomy for metacronous pancreas head metastasis of ascending colon cancer. The patient was a 68-year-old man who received right hemi-colectomy with regional lymphadectomy and partial hepatectomy in January 2005. Pathological examination revealed moderately differentiated adenocarcinoma (type2, pSi-duodenum, ly0, v2, pN1, pH1, sP0, cM0). At three years after the first operation, enhanced CT showed pancreas head lymph node swelling. He received FOLFIRI and FOLFOX chemotherapy. However, at 43 months after the first operation, CT revealed the enlarged lymph node. At 45 months after the first operation, a lymphadectomy of pacreas head was performed. The resected lymph node contained well-differentiated adenocarcinoma with viable cells. At 48 months after the first operation, CT showed pancreas head metastasis again. Chemo-radiation therapy reduced pancreas head metastasis in size. But the metastasis re-grew on CT at 53 months after the first operation. Therefore he received the pancreatico-duodenectomy to aim the curative resection at 54 months after the first operation. Successfully he has no recurrence at 34 months after the last operation.