Multiple liver metastases of pancreatic solid pseudopapillary tumor treated with resection following chemotherapy and transcatheter arterial embolization: A case report

Tajima,Hidehiro; Takamura,Hiroyuki; Kitagawa,Hirohisa; Nakayama,Akira; Shoji,Masatoshi; Watanabe,Toshifumi; Tsukada,Tomoya; Nakanuma,Shinichi; Okamoto,Koichi; Sakai,Seisho; Kinoshita,Jun; Makino,Isamu; Nakamura,Keishi; Hayashi,Hironori; Oyama,Katsunobu; Inokuchi,Masafumi; Nakagawara,Hisatoshi; Miyashita,Tomoharu; Ninomiya,Itasu; Fushida,Sachio; Fujimura,Takashi; Wakayama,Tomohiko; Iseki,Shoichi; Ikeda,Hiroko; Ohta,Tetsuo

doi:10.3892/ol.2015.2967

April-2015 Volume 9 Issue 4

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April-2015 Volume 9 Issue 4

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Case Report

Multiple liver metastases of pancreatic solid pseudopapillary tumor treated with resection following chemotherapy and transcatheter arterial embolization: A case report

Authors:
- Hidehiro Tajima
- Hiroyuki Takamura
- Hirohisa Kitagawa
- Akira Nakayama
- Masatoshi Shoji
- Toshifumi Watanabe
- Tomoya Tsukada
- Shinichi Nakanuma
- Koichi Okamoto
- Seisho Sakai
- Jun Kinoshita
- Isamu Makino
- Keishi Nakamura
- Hironori Hayashi
- Katsunobu Oyama
- Masafumi Inokuchi
- Hisatoshi Nakagawara
- Tomoharu Miyashita
- Itasu Ninomiya
- Sachio Fushida
- Takashi Fujimura
- Tomohiko Wakayama
- Shoichi Iseki
- Hiroko Ikeda
- Tetsuo Ohta
View Affiliations / Copyright

Affiliations: Department of Gastroenterologic Surgery, Kanazawa University, Graduate School of Medical Science, Kanazawa 920‑8641, Japan, Department of Histology and Embryology, Kanazawa University, Graduate School of Medical Science, Kanazawa 920‑8641, Japan, Division of Pathology, Kanazawa University, Graduate School of Medical Science, Kanazawa 920‑8641, Japan
Pages: 1733-1738
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Published online on: February 16, 2015

https://doi.org/10.3892/ol.2015.2967
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Abstract

A 33‑year‑old female was diagnosed with a solid pseudopapillary tumor (SPT) of the pancreas and multiple liver metastases at the Department of Gastroenterological Surgery, Ishikawa Prefectural Central Hospital (Kanazawa, Japan). Distal pancreatectomy and postoperative systemic chemotherapy with gemcitabine (GEM) and S‑1, an oral fluoropyrimidine derivative, was administered, however, liver metastases became enlarged and local recurrence occurred. Therefore, the patient was referred to the Department of Gastroenterologic Surgery at the Graduate School of Medicine (Kanazawa, Japan) for hepatic arterial infusion (HAI) chemotherapy. Oral S‑1 (80 mg/m2) was administered as well as HAI chemotherapy with GEM (1,000 mg/standard liver volume). Following 18 cycles, tumor sizes were reduced and 18‑fluorodeoxyglucose positron emission tomography (18FDG‑PET) examination revealed obvious reduction of tumor FDG uptake. Transarterial tumor embolization (TAE) was performed for the previously unresectable right subphrenic liver tumor, and the other tumors were surgically resected. The resected tumors were diagnosed as liver metastases and a local recurrence of SPT in the postoperative pathological examination, which revealed that the resected tumors were composed of sheets of bland cells, which were positive for CD10, CD56, vimentin, neuron‑specific enolase and α‑antitrypsin. The postoperative course was uneventful, and the patient is currently under observation at an outpatient clinic; postoperative adjuvant chemotherapy with oral S‑1 has continued, and additional TAE is planned. In the future, if the middle segment of the liver becomes enlarged, surgery for the residual right lobe tumor may be possible. This case demonstrates one method of SPT treatment: Preoperative HAI chemotherapy with GEM, plus oral S‑1 and TAE. If complete resection can be achieved, the majority of patients with SPT have a favorable prognosis. In patients with unresectable metastases from SPT, it is crucial to conduct systematic multimodal treatment to maximize treatment success.

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Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Multiple liver metastases of pancreatic solid pseudopapillary tumor treated with resection following chemotherapy and transcatheter arterial embolization: A case report

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Abstract

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