2020 Volume 45 Issue 6 Pages 842-848
A 70-year-old woman presented to our hospital with the complaints of epigastralgia, vomiting, and diarrhea. Plain computed tomography (CT) revealed dilatation of a short segment of the small bowel and a mass in the pancreatic body. Contrast-enhanced CT performed 2 days later revealed reduction in the degree of dilatation of the small bowel segment and gradual contrast enhancement of the mass in the pancreatic body. We suspected pancreatic body cancer and performed surgery. During laparotomy, we detected a small bowel tumor, and partial resection of the jejunum was performed for tumor removal, concomitantly with distal pancreatectomy and partial resection of the portal vein for the pancreatic body cancer. Histopathological examination of the resected specimen confirmed invasive ductal carcinoma of the pancreas with a small bowel metastasis. The patient received adjuvant S-1 chemotherapy postoperatively for 6 months. Local recurrence-induced obstructive jaundice occurred 8 months postoperatively, and an expandable metallic stent was placed for biliary drainage, and the patient was initiated on a 6-month course of gemcitabine plus nab-paclitaxel chemotherapy. Progressive local recurrence resulting in duodenal stenosis was detected 14 months after the pancreatectomy; therefore, the patient received duodenal metallic stent placement and supportive care. The patient died of advanced local recurrence 17 months after the pancreatectomy; however, no recurrence of the metastasis was identified.
