A Case of Small Carcinoma of the Pancreatic Body with Obturatory Node Metastasis

Junichi Mizutani, Katsuyoshi Taki, Kazuo Namikawa, Takeshi Syojima, Keisuke Araki, Tetsuya Yamaguchi

Department of Surgery, Kumamoto National Hospital

A case of small carcinoma of the pancreatic body with obturator node metastasis is reported. A 60-year-old woman underwent an extended total hysterectomy for squamous cell carcinoma of the uterine cervix on April 17, 1987, and histological examination revealed adenocarcinoma in the small obturator node. Morphologic techniques for detection of the primary lesion revealed small carcinoma of the pancreatic body. Distal pancreatectomy was performed on June 5. No swelling of the parapancreatic or paraaortic nodes could be found macroscopically. Histological examination of the pancreatic tumor, which measured 1.8×1.7 cm, showed mainly moderately differentiated tubular adenocarcinoma and the same findings were observed in the obturator node. These facts demonstrate the difficulty of intraoperative evaluation of the stage of carcinoma of the pancreas and that even in small carcinoma there can be further lymph node metastasis even if extended resection is carried out. Therefore we believe that multi-disciplinary treatment such as intra- and postoperative chemo- and immunotherapy is necessary in addition to extended resection even in small carcinoma of the pancreas.

Key words
small carcinoma of the pancreas, obturator node metastasis

Reprint requests
Jun-ichi Mizutani Department of Surgery, Kumamoto National Hospital
1-5 Ninomaru, Kumamoto, 860 JAPAN

Accepted
March 7, 1990

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