雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

検索

書誌情報 詳細検索 by 医中誌

Japanese

Diabetes Mellitus and Pancreatic Tumor pp.287-294
Published Date 2005/3/15
DOI https://doi.org/10.11477/mf.1427100049
  • Abstract
  • Look Inside

Cace1

A 65-year-old man under the control of diabetes showed deterioration of diabetes and ultrasonography showed a pancreatic head mass, measuring 1.5 cm. Computed tomography and magnetic resonance imaging also showed a pancreatic head mass with delayed enhancement. Endoscopic retrograde pancreatography showed a stenosis of the main pancreatic duct and dilatation of the upper stream ducts. Brushing cytology of the stenosis of the main pancreatic duct showed atypical cells highly suggestive of malignancy. Pylorus preserving pancreatoduodenectomy with D2 lymph node dissection was performed under the diagnosis of pancreatic head cancer. Intraoperative radiation therapy(20 Gy)was also done. Histological examination showed a well differentiated adenocarcinoma, measuring 1.5 cm. Lymph node metastasis was not evident and surgical margins were free of cancer cells. After operation, radiation therapy was added and transarterial chemotherapy was performed. Arterial rupture from pseudoaneurysm occurred 2 years and 7 months after the operation and he unfortunately died of bleeding without signs of recurrence on imagings.

Case2

A 62-year-old man was diagnosed as having diabetes mellitus and hepatocellular carcinoma on liver cirrhosis five years ago. Ethanol injection therapy was performed for hepatocellular carcinoma. During follow-up ultrasonography detected a pancreatic body mass, measuring 1.5 cm. Serum level of CA19―9 was elevated to 359.9 IU/ml and CEA within normal limits. Computed tomography and magnetic resonance imaging also showed a pancreatic tail mass with delayed enhancement. Endoscopic retrograde pancreatography showed a complete obstruction of the main pancreatic duct and dilatation of the upper stream ducts. Distal pancreatectomy and splenectomy with D2 lymph node dissection was performed under the tentative diagnosis of pancreatic body cancer. Histological examination showed a well differentiated adenocarcinoma, measuring 1.5 cm. Lymph node metastasis was evident in the level 1 lymph node. After operation, uncontrollable ascites occurred. He was alive six months after operation and lost at the follow-up thereafter.

(Shokakigazo 2005 ; 2 : 287―294)


Copyright © 2005, Igaku-Shoin Ltd. All rights reserved.

基本情報

電子版ISSN 1882-1227 印刷版ISSN 1344-3399 医学書院

関連文献

もっと見る

文献を共有