A Case of Pancreatic Body and Tail Cancer with Peritoneal Dissemination Followed up for 5 Years without Recurrence

Nobuhiko Ueda, Motomi Kawasaki, Seiko Uwafuji, Hajime Furuya, Hisatoshi Nakagawara, Shouichi Okada, Yutaka Yoshimitu, Kazuo Kinoshita and Toshiharu Sawa

Department of Surgery, National Hospital Organization Fukui National Hospital

We report a case of pancreatic body and tail cancer with peritoneal dissemination followed up for 5 years without recurrence after resection of the organ of origin and peritoneal dissemination with continuous hyperthermic peritoneal perfusion (CHPP). A 60-year-old man found in abdominal CT to have an irregular low-density tumor about 4 cm long at the pancreatic body and tail was further found in abdominal angiography to have an irregularity of the splenic artery wall and a splenic vein obstruction. Preoperative cytology of the abdominal cavity was class II. Under a diagnosis of pancreatic body and tail cancer, surgery was done. Operative findings showed a tumor about 4 cm long at the pancreatic body and tail and 2 peritoneal rice-grain-sized disseminations on the mesenterium of the transverse colon. After distal pancreatectomy and splenectomy with D₁ lymph node dissection and partial resection of the transverse colon mesenterium, CHPP with 300 mg of CDDP, 30 mg of MMC, and 300 mg of VP-16 was administered. Pathologically, this case was pT₄, pN₀, pM₁ (PER), and pStage IVb. After 6 postoperative cycles of arterial chemotherapy with 50 mg of CDDP and 100 mg of VP-16, the man has been followed up for 5 years without evidence of recurrence.

Key words
pancreas cancer, peritoneal dissemination, continuous hyperthermic peritoneal perfusion

Reprint requests
Nobuhiko Ueda Department of Surgery, National Hospital Organization Fukui National Hospital
33-1 Sakuragaoka-cho, Tsuruga, 914-0195 JAPAN

Accepted
May 25, 2004

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