Curative Surgery for Metachronous Multiple Liver Metastases from Pancreatic Glucagonoma after Distal Pancreatectomy

Q4 Medicine
Akihiro Kohata, Tomoyuki Abe, Tsuyoshi Kobayashi, Masashi Inoue, Hideki Ohdan, Kazuhiro Toyota, Tadateru Takahashi
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引用次数: 0

Abstract

Pancreatic glucagonoma is a well-known rare subtype of pancreatic neuroendocrine tumors (PNETs). Most cases of pancreatic glucagonoma are associated with symptoms such as skin rash and necrotizing migratory erythema; however, some cases are asymptomatic. Complete tumor resection has an important impact on the long-term prognosis of patients with primary PNETs. The 2019 edition of the Japanese Guidelines for Neuroendocrine Tumors recommends recurrent lesions of pancreatic and gastrointestinal NETs to be treated multimodally, including resection if the lesions are curatively resectable. However, no treatment strategy has been established for recurrent pancreatic glucagonoma. We report the case of a patient who underwent distal pancreatectomy for primary pancreatic glucagonoma and developed multiple hepatic metastatic recurrences five years after the primary surgery. After two and a half years of somatostatin analog (SSA) treatment, neither tumor growth nor extrahepatic recurrence was detected, and curative surgery was performed. This study reports a rare case of complete resection for multiple metachronous liver metastases from a pancreatic glucagonoma after curative surgery. During SSA therapy, the metastatic tumors showed a very slow growth pattern. No other distant extrahepatic metastases emerged. Curative hepatectomy was performed safely, and the postoperative course was uneventful.
远端胰切除术后异时多发胰高血糖素瘤肝转移的手术治疗
胰高血糖素瘤是一种罕见的胰腺神经内分泌肿瘤(PNETs)。大多数胰高血糖素瘤病例伴有皮疹和坏死性迁移性红斑等症状;然而,有些病例是无症状的。肿瘤完全切除对原发性PNETs患者的远期预后有重要影响。2019年版的《日本神经内分泌肿瘤指南》建议,胰腺和胃肠道NETs的复发性病变应采用多模式治疗,如果病变可以治愈切除,则应进行切除。然而,对于复发性胰高血糖素瘤尚无治疗策略。我们报告了一例因原发性胰高血糖素瘤而行远端胰腺切除术的患者,并在原发性手术五年后发生了多发性肝转移复发。经过两年半的生长抑素类似物(SSA)治疗,未发现肿瘤生长或肝外复发,并进行了根治性手术。本研究报告一例罕见的胰脏胰高血糖素瘤在根治性手术后,完全性切除多发性异时性肝转移的病例。在SSA治疗期间,转移性肿瘤表现出非常缓慢的生长模式。未出现其他远端肝外转移。治疗性肝切除术安全进行,术后过程平稳。
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来源期刊
Surgery, Gastroenterology and Oncology
Surgery, Gastroenterology and Oncology Medicine-Gastroenterology
CiteScore
0.30
自引率
0.00%
发文量
11
期刊介绍: Starting with this issue "Annals of Fundeni Hospital", founded in 1996 as the scientific journal of the prestigious hospital Fundeni becomes "Journal of Translational Medicine and Research" (JTMR), an Journal of the Academy of Medical Sciences of Romania. Therefore, an 18 years old Journal, attested and indexed in Elsevier Bibliographic Databases, Amsterdam and also indexed in SCOPUS, is continuing a tradition of excellence that lasted almost two decades. The new title of the Journal is inspired first of all from the important developments of translational research In Fundeni Clinical Institute and the "C.C Iliescu Institute for Cardio-Vascular Diseases", in parallel with the national and international trend to promote and develop this important area or medical research. Although devoted mainly to translational research, JTMR will continue to promote both basic and clinical research.
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