長期生存をえている十二指腸乳頭部癌異時性肝転移切除の１例

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  • A long-team survival case after a right extended hepatectomy for metachronous hepatic metastasis of carcinoma of the papilla Vater.

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Although carcinoma of the papilla Vater is said to have relatively good prognosis, it is not uncommon to recur. We present a patient with carcinoma of the papilla Vater who had experienced hepatic recurrence 5 years after pancreatoduodenectomy and has been recurrence free for further 5 years or more after extended right lobectomy of the liver for the hepatic metastasis.<br> A 41-year-old woman complaining of fever and jaundice underwent a pancreatoduodenectomy for carcinoma of the papilla Vater in October 1989. Histopathologically, it was papillary adenocarcinoma, pat Acbpd, panc0, dul, n0, and stageII. Five years after the operation, the patient was seen at the hospital because of fever, and was found to have simple hepatic metastasis about 10cm in size with necrotic center in the right lobe of the liver (S8). An extended right lobectomy of the liver was performed for the metachronous hepatic metastasis. At the same time, the diaphragm involving by the tumor was removed.<br> The patient has been alive without recurrence for more than 5 years after hepatectomy. We suggest that hepatic resection for hepatic metastasis of carcinoma of the papilla Vater should be performed if it is possible that might lead to long-term survival for the patient. We report this very rare case, in which long-term survival could be achieved after hepatectomy for hepatic metastasis of carcinoma of the papilla Vater.

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