緊急手術を要した退形成性膵管癌の１例

• Material Type: 記事
• Title: 緊急手術を要した退形成性膵管癌の１例
• Author Heading: 梅北 信孝; 蕨 雅大; 井上 暁; 佐藤 雄哉; 野田 和雅
• Publication Date: 2011
• Publication Date (W3CDTF): 2011
• Periodical title: 日本臨床外科学会雑誌
• No. or year of volume/issue: 72 6
• Volume: 72
• Issue: 6
• Pages: 1541-1546
• Publication date of volume/issue (W3CDTF): 2011
• ISSN (Periodical Title): 13452843
• Publication (Periodical Title): Japan Surgical Association
• Text Language Code: ja
• Subject Heading: anaplastic carcinoma; plemorphic carcinoma; emergent operation; 退形成性膵管癌; 多形細胞癌; 緊急手術
• Target Audience: 一般
• DOI: 10.3919/jjsa.72.1541; https://doi.org/10.3919/jjsa.72.1541
• Related Material (URI): http://www.jstage.jst.go.jp/article/jjsa/72/6/72_6_1541/_pdf; https://search.jamas.or.jp/link/ui/2011267796
• Is Referenced By: 巨大な膵退形成癌の１切除例; https://cir.nii.ac.jp/crid/1390869003306966016
• References: Undifferentiated carcinoma of the pancreas: analysis of intermediate filament profile and Ki-ras mutations provides evidence of a ductal origin; https://cir.nii.ac.jp/crid/1361137045606579328; Carcinoma of pancreas simulating giant cell tumor of bone. Electron-microscopic evidence of its acinar cell origin; https://cir.nii.ac.jp/crid/1361418521142297216; Endoscopic ultrasound‐guided fine‐needle aspiration of undifferentiated carcinoma with osteoclast‐like giant cells of the pancreas: A report of 2 cases with literature review; https://cir.nii.ac.jp/crid/1361418521144854528; Pathomorphologic study of undifferentiated carcinoma in seven cases: relationship between tumor and pancreatic duct epithelium; https://cir.nii.ac.jp/crid/1361699994685122432; A clinicopathologic and immunohistochemical study of 35 anaplastic carcinomas of the pancreas with a review of the literature; https://cir.nii.ac.jp/crid/1362825894907621376; Heterogeneity in the incidence and clinical manifestations of disseminated intravascular coagulation: A study of 204 cases; https://cir.nii.ac.jp/crid/1362825896119036928; Spindle cell carcinoma of the pancreas; https://cir.nii.ac.jp/crid/1364233270879227392; 破骨細胞型退形成性膵管癌の１例; https://cir.nii.ac.jp/crid/1390001204849796992; 自然破裂による腹腔内出血を呈した退形成性膵管癌（巨細胞型）の１例; https://cir.nii.ac.jp/crid/1390001204919083520; 術後早期再発を来した１．５ｃｍ径の退形成性膵管癌（紡錘細胞型）の１例; https://cir.nii.ac.jp/crid/1390001204920074880; １０年以上の生存が得られた退形成性すい管癌の３切除例; https://cir.nii.ac.jp/crid/1390282679614508288; ６か月の自然経過を観察した破骨細胞型退形成性膵管癌の１切除例; https://cir.nii.ac.jp/crid/1390282679615436032; 腹腔内出血で発症したすい巨細胞癌の１例; https://cir.nii.ac.jp/crid/1390282679890993664
• Data Provider (Database): 国立情報学研究所 : CiNii Research; https://cir.nii.ac.jp/
• Original Data Provider (Database): Japan Link Center; https://japanlinkcenter.org/top; Crossref; https://www.crossref.org; CiNii Articles
• NAID: 130004517894; 10029612681

• Summary, etc.: We report a case of anaplastic carcinoma, which required a emergent operation. A 69-year-old man underwent a right hepatic lobectomy for HCC (hepatocellular carcinoma) in September 2006. In October 2007, abdominal CT (computed tomography) detected a hepatic tumor. We diagnosed it as HCC and planned to perform a hepatectomy. The CT scan also detected a cystic tumor of the pancreas tail. In December 2007, he had sudden epigastric pain, and visited our hospital. Abdominal CT detected rapid growth of the cystic tumor. Hemorrhagic fluid was obtained by percutaneous needle aspiration. He also had progressing DIC (disseminated intravascular coagulation). We suspected a rapidly growing malignant pancreas tumor, and performed a emergent distal pancreatectomy. We also performed a partial hepatectomy for the hepatic tumor. The pathological diagnosis was anaplastic carcinoma of the pancreas (Plemorphic type), and hepatic metastasis. Post operative course was good and he was discharged, but 71 days after the operation anaplastic carcinoma recurred, and 92 days after the operation he died.; 患者は69歳，男性．2006年9月肝細胞癌に対し肝右葉切除術を施行した．2007年10月のCTにて残肝S2に結節影を認め，肝細胞癌の再発と考え手術予定とした．また，この時のCTで膵尾部の周囲に嚢胞状腫瘤を認めた．2007年12月突然心窩部痛が出現した．CTにて嚢胞状腫瘤の急激な増大を認めた．経皮的に腫瘍を穿刺したところ，内容物は血性であった．進行するDICも認めたため，急速に進行する膵原発の悪性腫瘍と考え，緊急で膵体尾部切除術を施行した．また，肝外側区域の結節に対し，肝部分切除術を施行した．膵尾部の腫瘍は病理組織所見にて退形成性膵管癌（多形細胞癌）と診断され，肝腫瘍は退形成膵管癌の転移と診断された．術後の経過は良好で退院したが，術後71日目再発を認めた．その後全身状態が急激に悪化し，術後92日目に死亡した．
• DOI: 10.3919/jjsa.72.1541
• Access Restrictions: インターネット公開
• Data Provider (Database): 科学技術振興機構 : J-STAGE; http://www.jstage.jst.go.jp