A Case of Recurrent Ascending Colon Cancer in the Pancreatic Head Region Treated by Pancreaticoduodenectomy

Kiyoshi Suzumura, Akihiro Yamaguchi, Masatoshi Isogai, Tohru Harada, Yuji Kaneoka, Masahiko Suzuki, Atsushi Akutagawa, Gen Sugawara and Tatuya Usui

Department of Surgery, Ogaki Municipal Hosppital

We report a case of recurrent ascending colon cancer in the pancreatic head 16 months after right hemicolectomy treated by pancreaticoduodenectomy. Case report: Barium contrast radiography of the upper gastrointestinal tract showed an obstruction in the duodenum of a 45-year-old woman. Computed tomography showed a lesion with central necrosis extending from the pancreatic head to the third portion of the duodenum. Portograpy showed that the mass lesion compressed the superior mesenteric vein. The patient underwent radical surgery to resect the ileum and transverse colon, plus pancreaticoduodenectomy and partial resection of the superior mesenteric vein and of liver. Pathological examination showed a metastatic tumor in the pancreatic head. Central necrosis was noted 3 cm in diameter. Fistula formation was observed between the duodenum and transverse colon through the necrotic cavity. Although the patient was discharged on postoperative day 36, she died of liver metastasis 192 days after surgery. Although prognosis is generally poor, pancreaticoduodenectomy is indicated in resectable cases of metastatic pancreatic disease from colon cancer.

Key words
pancreatic tumor, pancreatic metastasis, recurrence of rectal cancer

Reprint requests
Kiyoshi Suzumura Department of Surgery, Ogaki Municipal Hospital 4-86 Minaminokawa-cho, Ogaki, 503-0864 JAPAN

Accepted
July 30, 2001

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