A CASE OF AMPULLARY CARCINOMA WITH A JUMPING METASTASIS TO PARAAORTIC LYMPH NODE
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- KAWAMOTO Masahiko
- Department of Surgery I, Kyushu University Faculty of Medicine
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- SHIMIZU Shuji
- Department of Surgery I, Kyushu University Faculty of Medicine
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- CHIJIIWA Kazuo
- Department of Surgery I, Kyushu University Faculty of Medicine
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- YAMAGUCHI Koji
- Department of Surgery I, Kyushu University Faculty of Medicine
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- TAKASHIMA Masaki
- Department of Pathology II, Kyushu University Faculty of Medicine
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- TANAKA Masao
- Department of Surgery I, Kyushu University Faculty of Medicine
Bibliographic Information
- Other Title
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- 大動脈周囲リンパ節に跳躍転移の認められた十二指腸壁内乳頭部癌の1例
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Abstract
A case of ampullary carcinoma with a jumping metastasis to the paraaortic lymph node is presented. A 51-year-old woman was admitted to the hospital because of epigastrial discomfort. Liver dysfunction had been noticed since one year before without a history of jaundice. CA 19-9 level elevated. Intrahepatic bile duct dilatation was detected by ultrasound and computed tomography. Hypotonic duodenography showed a protruded mass, 4cm in size, which was well differentiated adenocarcinoma by endoscopic biopsy. There was no ascites, liver metastasis or peritoneal dissemination on laparotomy. An elastic hard tumor was palpable at the second portion of the duodenum without any invasion to the serosa. A pylorus-preserving pancreatico-duodenectomy was performed with extended lymph node dissection including paraaortic regions, and with intraoperative radiation. The mass was an exposed protruding type, invading the submucosa of the duodenum. The only one paraaortic lymph node was metastasized of all 55 dissected lymph nodes. We conclude that there is a direct stream of lymph from the papilla to paraaorta and that the paraaortic lymph node dissection would be mandatory for surgery of ampullary carcinoma even in an early stage.
Journal
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- Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)
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Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 59 (10), 2582-2586, 1998
Japan Surgical Association
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Details 詳細情報について
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- CRID
- 1390282679826703360
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- NII Article ID
- 130003600669
- 10008436641
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- NII Book ID
- AA11189709
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- ISSN
- 18825133
- 13452843
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- Data Source
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- JaLC
- Crossref
- CiNii Articles
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- Abstract License Flag
- Disallowed