Abstract
We report a case of resected remnant pancreatic cancer from a 58-year-old man who underwent pylorus preserving pancreaticoduodenectomy (PPPD) for cancer of the papilla of Vater. The pancreatic surgical margin was free of cancer cells. Four years after PPPD, a follow-up abdominal CT showed a pancreatic tumor with invasion into the splenic artery. With the diagnosis of remnant pancreatic cancer, he underwent completion pancreatectomy with splenectomy, partial resection of the stomach and left adrenal gland. Histopathological diagnosis was moderately differentiated tubular adenocarcinoma originated from the pancreas. He received liver perfusion chemotherapy with 5-fluorouracil and systemic gemcitabine chemotherapy after completion pancreatectomy. He is alive without recurrence 4 years 3 months after the second surgery. It is extremely rare that metachronous double cancer of the papilla of Vater and the remnant pancreas were curatively resected, and we consider that aggressive surgery and chemotherapy are useful for remnant pancreatic cancer after PPPD.
