すい中央切除術で５年生存が得られたすい体部小すい管癌の２例

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  • 2 Long Term Survival Cases of Small Pancreatic Cancers Performed Middle Pancreatectomy

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We conducted middle pancreatectomy in 2 patients who had small pancreatic cancer measuring 1cm in diameter. Case 1: A 72-year-old woman seen for epigastralgia was found in ultrasonic examination to have a tumor on the pancreatic body. Further examination led to a diagnosis of small pancreatic cancer, necessitating middle pancreatectomy. The pathological diagnosis was moderately differentiated tubular adenocarcinoma type stage I. The patient remains alive without recurrence 5 years and 7 months after surgery. Case 2: A 68-year-old man with a dilated pancreatic duct and a pancreatic body tumor which were detected ultrasonically during routine screening was found on. further examinations to have a small cancer on the pancreatic body, for which the patient underwent middle pancreatectomy. The pathological diagnosis was moderately differentiated tubular adenocarcinoma stage IV a. The patient remains free of recurrence 5 years and 3 months after surgery. Extended surgery is generally indicated even when the tumor diameter is relatively small because of the high incidence of vascular invasion and metastasis. In addition to morphological diagnosis, we evaluated the expression of thrombospondin-1 and epidermal growth factor receptor as molecular markers associated with cancer invasion and metastasis. We suggest these molecular markers point to the possibility of nonextended operation in pancreatic cancer with low-grade metastatic potential.

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