Article ID: JNMS.2019_86-502
We report a case of metastatic pancreatic-head mucinous carcinoma (with multiple lymph node and bone metastases), as well as a literature review. Endoscopic ultrasound - fine needle aspiration (EUS-FNA) was useful for diagnosis in this patient, and a satisfactory outcome was achieved using systemic chemotherapy with FOLFIRINOX followed by resection of the primary lesion as conversion surgery. The patient was a 55-year-old man. Hematological findings included elevated serum tumor marker levels: CEA at 12.7 ng/ml and DUPAN-2 at 400 U/ml. With several modalities and EUS - FNA, the patient received a clinicopathological diagnosis of metastatic pancreatic mucinous carcinoma with multiple bone and lymph node metastases. For systemic chemotherapy, five courses of modified FOIFIRINOX (m-FFX) were given, and an antitumor effect was obtained; therefore, subtotal stomach-preserving pancreaticoduodenectomy and extensive lymph-node dissection were performed. Histopathologically, the results were invasive ductal carcinoma, muc (pT3, pN1b, cM1). After surgery, the clinical course was notable for the absence of complications. Tegafur/gimeracil/oteracil (S-1) was started as maintenance adjuvant chemotherapy postoperatively. And, the patient is still ongoing progression-free survival 10 months after the surgery.