Recurrence of gastric cancer invading the main pancreatic duct: A case report

Hiroshi Maekawa, Hajime Orita, Mutsumi Sakurada, Tomoyuki Kushida, Tomoaki Ito, Koichi Sato
2015 International Journal of Case Reports and Images  
International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties. Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations. ABSTRACT Introduction:
more » ... TRACT Introduction: Locoregional recurrence of gastric cancer is sometimes seen in clinical practice, but the finding of intraductal spread to the main pancreatic duct is unique. Here, we report a case of recurrent gastric cancer involving the main pancreatic duct caused by lymphatic spread into the pancreas. Case Report: A 76-years-old female was admitted to our hospital because of abnormality of the pancreas without symptoms. She had been treated with distal gastrectomy due to locally advanced gastric cancer 24 months before admission. Computed tomography scan showed a swelling in the pancreatic body containing a low-density area. MRI scan revealed that the lowdensity area of the central pancreas was the main pancreatic duct dilated and filled with a tumor. Resection of the gastric remnant with distal pancreatectomy and splenectomy were performed under a diagnosis of a primary pancreatic tumor or gastric cancer recurrence. Pathological examination revealed that a tubular adenocarcinoma packed the main pancreatic duct, and the same neoplasm infiltrating the pancreatic parenchyma was also found. Finally, we diagnosed the lesion as the lymphatic recurrence of gastric cancer. The patient had survived for 12 months since metastasectomy without signs of recurrence. Conclusion: Recurrence of gastric cancer sometimes invades to pancreatic parenchyma and mimics the intraductal pancreatic neoplasm. If the complete resection of locoregional recurrence of gastric cancer is performed, surgical treatment will contribute to prolonging the survival. AbstrAct Introduction: Locoregional recurrence of gastric cancer is sometimes seen in clinical practice, but the finding of intraductal spread to the main pancreatic duct is unique. Here, we report a case of recurrent gastric cancer involving the main pancreatic duct caused by lymphatic spread into the pancreas. case report: A 76-years-old female was admitted to our hospital because of abnormality of the pancreas without symptoms. she had been treated with distal gastrectomy due to locally advanced gastric cancer 24 months before admission. computed tomography scan showed a swelling in the pancreatic body containing a low-density area. MrI scan revealed that the low-density area of the central pancreas was the main pancreatic duct dilated and filled with a tumor. resection of the gastric remnant with distal pancreatectomy and splenectomy were performed under a diagnosis of a primary pancreatic tumor or gastric cancer recurrence. Pathological examination revealed that a tubular adenocarcinoma packed the main pancreatic
doi:10.5348/ijcri-201562-cr-10523 fatcat:vvozxuoqxbgeno3e3wdjrdokqe