A Case of Intraductal Papillary Mucinous Carcinoma Treated by Resection of the Stomach, Jejunum, Colon, Left Kidney, and Pancreatic Tail

Abstract

A 74-year-old man underwent transverse colostomy to treat simple intestinal obstruction due to the infiltration of intraductal papillary mucinous carcinoma (IPMC) of the pancreas into the colon. He subsequently continued chemotherapy with gemcitabine (plus nab-paclitaxel) and FOLFIRINOX. The tumor decreased in size, but chemotherapy was nevertheless continued at the patient's request. However, 39 months after the initial surgery it became impossible to continue chemotherapy due to repeated infected pancreatic pseudocysts, and he was referred for surgery. Resection of the stomach, jejunum, colon, left kidney, and pancreatic tail was performed. Histopathologically, the tumor was invasive IPMC, pT3, S1, RP1, OO1 (small bowel and colon), N1a, pStage IIB, and RP-positive, but no exposure of the carcinoma was evident on the dissected surface. S-1 was administered as postoperative adjuvant chemotherapy, and today, 9 months after surgery, the patient is surviving recurrence-free. There have been few cases of pancreatic cancer requiring resection of the left kidney, and this case is reported together with a short discussion of the literature.