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A Case of Pancreas Body Cancer: Diagnosed by angiography and treated curative operation Y. Uematsu 1 , K. Nara 1 , M. Kitajima 1 , M. Ito 1 , Y. Nakajima 2 1The Surgical Department of the Ashikaga Red Cross Hospital 2Maro Clinic pp.1571-1574
Published Date 1974/12/25
DOI https://doi.org/10.11477/mf.1403111710
  • Abstract
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 The early diagnosis and curative resection of the pancreas cancer is still difficult, in spite of the recent progress in the diagnostic procedures. Using the selective angiography a very small pancreas body cancer as small as 2 cm in diameter could be diagnosed and successfully operated. An old housewife 64 years of age had been suffered from left back pains of three years duration, any abdominal pain, weight loss, or jaundice. An abdominal mass, 6×3 cm in size was palpated in the left upper abdominal quadrant. The patient was transferred to our surgical ward on Nov. 8. 1973.

 In the laboratory findings, serum and urine amylase levels were increased. The glucose tolerance test was slightly abnormal. Another findings all were within normal limits. Gastrointestinal series revealed light compression on the posterior wall of the body of the stomach. No abnormal findings was observed by gastroduodenoscopy. Catheterization into the pancreatic duct was impossible at pancreatography, in despite of our carefull efforts. In the selective caeliac angiography, splenic, common hepatic arteries were normal. The dorsal pancreatic artery was obstructed with dilatation and irregular encasement. Abnormal small vessels were visualized in the pancreas body. The configuration of this abnormal vascularization measured rounded about 2 cm in diameter. In the capillary phase, the increased parenchymal accumulation of the contrast medium was not revealed in the mass but in the pancreas tail. In the venous phase, splenic vein was displaced and compressed upward with doom formation and diffuse narrowing. Following the arteriographic findings it may probably be diagnosed as a small pancreas body cancer with chronic pancreatitis. Curative operation was performed on Dec. 8. 1973. In the pancreas body, the grayish white tumor was visible. There was no invasion and no metastasis. Hystological diagnosis was adenocarcinoma tubulare with mucinous cells and scirrhous, other non tumorous region was chronic pancreatitis. Postoperative course was uneventful and discharged on 21 th postoperative day. After the operation, glucose tolerance test was slightly abnormal but soon returned to the normal pattern. Mitomycin C, 5-Fu and cylocide were given as anticancerous chemotherapy for 5 weeks. Nine months after the operation, the patient is in good condition and no sign of recurrence.


Copyright © 1974, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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