A Resected Case of the Pancreatic Tail Cancer with Obstruction of the Large Intestine

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  • 結腸閉塞を契機に発見された膵尾部癌の１切除例

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Abstract

A 70-year-old man with intestinal obstruction was admitted to our hospital. Contrast-enhanced computed tomography revealed a tumor approximately 6cm in diameter involving the pancreas, stomach, spleen and splenic flexure; the proximal intestine was enlarged. Colonoscopy showed a lesion at the splenic flexure, and the biopsy of this lesion indicated tubular adenocarcinoma. Preoperatively, we made a diagnosis of intestinal obstruction caused by cancer of the pancreatic tail with direct invasion to the surrounding organs, and resection was performed with curative intent. The origin of the tumor was the pancreatic tail, and we performed en-bloc resection of the pancreatic tail, spleen, partial colon, partial stomach, and partial diaphragm. The tumor was histologically diagnosed as a well-differentiated tubular adenocarcinoma of pancreas with direct invasion to the surrounding organs. Eleven months after the operation, the patient died from recurrence of pancreatic tail cancer. Generally, patients who have pancreatic tail cancer with direct invasion to the surrounding organs have poor prognosis, even when extended resection is performed. Therefore, indication of extended resection for advanced pancreatic cancer should be carefully determined.

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