Abstract
A 77-year-old man was diagnosed as having a pancreatic cancer, and was treated by systemic gemcitabine biweekly. Though some effect of gemcitabine on the pancreatic cancer was shown by changes in the serum CA19-9 level and CT examination during the first several months, he died at 9-months. Pathological evaluation disclosed necrosis, vacuolation of carcinoma cells, phagocytosis by macrophages, and fibrosis in one third of the pancreatic tumor, consistent with the anti-tumor effect of gemcitabine. The other part of the pancreatic lesion and liver metastasis consisted of well differentiated tubular adenocarcinoma cells and necrosis which showed a resistant status to gemcitabine. In this case, we confirmed by pathological findings the effects of gemcitabine on part of the pancreatic tumor. In addition, this case shows the urgent need for second line chemotherapies and for effective therapies for metastatic liver lesions.
