A case of metachronous multiple pancreatic cancer that sets up 9 years after the initial operation for pancreatic cancer with osteoclast-like giant cell tumor of the pancreas

Abstract

A distal pancreatectomy for osteoclast-like giant cell tumor of the pancreas was performed on a 66-year-old male 9 years ago (1999). He has since been followed-up monitoring imaging and tumor markers. In February 2008, his serum CA19-9 level was elevated, which suggested the recurrence of pancreatic cancer. PET/CT, as well as FDG accumulation, disclosed a mass lesion at the head of the pancreas. Based on these findings, he was diagnosed with pancreatic cancer [T4 (TS2, CH (-), DU (-), S (+), RP (+), PV (+), A (-), PL (-), OO (-)) N2M0, Stage IVb]. A pancreatoduodenectomy was begun, however, it was aborted because of macroscopic invasion into nerve plexuses around the celiac artery. Chemotherapy using gemcitabine was then started on this patient.
This is quite a rare case in which pancreatic cancer (tubular adenocarcinoma) developed 9 years after the resection of another pancreatic cancer (giant cell carcinoma of osteoclast) type.