術後22年目に再発した乳癌膵転移の1例

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  • A CASE OF PANCREATIC METASTASIS OF BREAST CANCER WHICH RECURRED 22 YEARS AFTER OPERATION

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We experienced a case of breast cancer metastasized to the pancreas 22 years after operation for the primary lesion. A 60-year-old woman was admitted to the hospital because of fever and jaundice. Preoperative imaging methods indicated a tumor of the pancreatic head, but apparent findings of metastatic pancreatic cancer were lacked. Since there was a previous history of undergoing a resection for pulmonary metastatic foci 11 years before admission, pancreatic metastasis of breast cancer or primary pancreatic cancer was diagnosed. A pancreatoduodenectomy was performed. Pathological exploration of the resected material revealed entirely similar findings to those of primary breast cancer and pulmonary metastatic foci, which were compatible with pancreatic metastasis of breast cancer.<br> It is very rare that pancreatic metastasis of cancer is indicated for surgical resection. Although this patient presented difficulty in differentiation from primary pancreatic cancer, she was determined to be a candidate for operation based on the following reasons: 1) Imagings revealed the foci localized in the pancreas and its circumference: 2) If the tumor was metastatic pancreatic tumor, it was slow growing and 11 years had past after the operation for lung metastasis: and 3) Patient's preoperative general condition was good. As of one year after the resection, the patient is being followed in the outpatient clinic, though she has another recurrence.

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