A Long-term Survival Case of Pancreas Tail Cancer with Colonic Obstruction

Michiya Kobayashi, Kimio Matsuura, Keijiro Araki, Eisuke Kashiwai, Naoshige Tochika, Seiya Nakamura, Takuro Ogata

First Department of Surgery, Kochi Medical School

A 52-year-old woman had had abdominal pain and sequential constipation and diarrhea since March 1989. She complained of abdominal pain and vomiting, and was admitted to the hospital with the diagnosis of ileus. Barium enema study demonstrated a colonic obstruction at the splenic flexure. She was diagnosed as having colon cancer and was transferred to our hospital. The level of tumor markers carbohydrate antigen 19-9 and ferritin were 1,260 U/ml (<38) and 150 ng/ml (10-80), respectively. Transverse colostomy was performed on June 26, 1989. Endoscopic examination of the colon showed marked stenosis. However, endoscopic biopsy of the colonic mucosa did not reveal any cancer cells. She underwent surgery on July 11, 1989. Cancer of the pancreas tail invading to the spleen, colon, and renal capsule was revealed by frozen section. Distal pancreatectomy with left hemi-colectomy, left nephrectomy, and intraoperative irradiation of 25 Gy with 10 MeV around the paraaortic region including renal artery were performed. She is alive without recurrence of pancreatic cancer 6 years after the operation.

Key words
pancreas tail cancer, colonic obstruction due to pancreas cancer, long-term survivor of pancreatic cancer

Reprint requests
Michiya Kobayashi First Department of Surgery, Kochi Medical School
Oko-cho, Nankoku, 783 JAPAN

Accepted
October 11, 1995

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