RESUMEN
A 35-year-old man presented with the complaint of epigastric discomfort. Gastrointestinal endoscopy and endoscopic ultrasonography revealed a cystic lesion 20 mm in size at the ampulla of Vater. Endoscopic retrograde cholangiopancreatography (ERCP) revealed that the cystic lesion communicated with both the common bile duct and pancreatic duct via the common channel. Choledochocele was ruled out by close examination of the ERCP findings. The cystic lesion was surgically resected. Since histological findings revealed that the mucosa inside the lesion was duodenum-like and contained a layer of smooth muscle, the lesion was diagnosed as a congenital duplication cyst of the duodenum.
Asunto(s)
Quistes/diagnóstico , Enfermedades Duodenales/diagnóstico , Adulto , Ampolla Hepatopancreática/patología , Colangiopancreatografia Retrógrada Endoscópica , Quiste del Colédoco/diagnóstico , Quiste del Colédoco/patología , Conducto Colédoco/patología , Quistes/genética , Quistes/patología , Diagnóstico Diferencial , Enfermedades Duodenales/genética , Enfermedades Duodenales/patología , Duodeno/anomalías , Humanos , Masculino , Conductos Pancreáticos/patologíaRESUMEN
A 30-year-old woman was referred to us because of hypoglycemic attack. The tumor on the pancreatic body of 22 mm size was revealed by close inspection, and was diagnosed as insulinoma. Surgical resection was performed, but curative resection was impossible because the component of adenocarcinoma infiltrating into surrounding tissue coexisted with insulinoma. Postoperatively, we make a diagnosis of combined tumor of the pancreas, i.e. mixed duct-islet cell carcinoma. In this paper, we discuss this rare disorder and summarize 33 cases reported in the Japanese literature.
Asunto(s)
Carcinoma de Células de los Islotes Pancreáticos/diagnóstico , Carcinoma Ductal Pancreático/diagnóstico , Insulinoma/diagnóstico , Neoplasias Primarias Múltiples , Neoplasias Pancreáticas/diagnóstico , Adulto , Carcinoma de Células de los Islotes Pancreáticos/patología , Carcinoma Ductal Pancreático/patología , Femenino , Humanos , Insulinoma/patología , Neoplasias Pancreáticas/patología , Tomografía Computarizada por Rayos XRESUMEN
We administered oral TS-1 alone for locally advanced pancreatic cancer that did not respond to gemcitabine (GEM). A 56-year-old man was admitted to our hospital because of obstructive jaundice due to stage III pancreatic head cancer. We performed chemotherapy using GEM at a dose of 1,000 mg/m(2) after reduction of jaundice by PTCD and stenting. Once the tumor was reduced, enlargement was confirmed after 8 months, and cholangitis appeared due to stent obstruction. After PTCD and stenting (stent in stent) were performed again,we administered oral TS-1 alone at a dose of 100 mg/body. We achieved antitumor activity again using TS-1. It is suggested that TS-1 is a useful second-line agent for pancreatic cancer.
