Abstract
A 69-year-old man underwent distal gastrectomy (B-I reconstruction) for a gastric ulcer 43 years ago and subsequently underwent total gastrectomy for residual stomach cancer (Epstein-Barr virus-related) in January 2015.
After total gastrectomy, he underwent adjuvant chemotherapy for 1 year, but computed tomography revealed a mass 3 cm in diameter in the body of the pancreas 20 months after total gastrectomy. He was diagnosed with metastasis of gastric cancer based on endoscopic ultrasound-guided fine needle aspiration biopsy. Because he achieved size reduction of the tumor (partial response) after 4 courses of SOX (S-1+L-OHP) therapy, we successfully performed distal pancreatectomy in February 2017.
Four courses of SOX therapy were administered as adjuvant chemotherapy, and there have been no signs of recurrence for 15 months postoperatively.
Cases of gastric cancer metastasis to the pancreas requiring surgical resection are limited, but if the tumor is localized in the pancreas and responsive to chemotherapy, and if there is no evidence of metastasis in other body regions, surgical resection combined with chemotherapy can be the treatment of choice.
