Four cases of resected remnant pancreatic cancer

Abstract

We report 4 cases of resected remnant pancreatic cancer. During initial surgery, the depth of invasion was T3 in 3 cases and T4 in 1 case. Lymph node metastasis was observed in 2 cases. Classification was Stage III for 2 cases, Stage IVa for the remaining cases. The interval between initial pancreatectomy and diagnosis of remnant pancreatic cancer were 24 months, 29 months, 54 months and 100 months, respectively. Total remnant pancreatectomy was performed after distal pancreatectomy in 2 cases, and after pancreaticoduodenectomy in 1 case. In the remaining 1 case whereby the patient underwent pancreaticoduodenectomy in initial surgery, the pancreatic tail and spleen were resected, preserving the pancreatic body. We believe that distinguishing metachronous lesions from recurrent ones is beneficial. Recurrence was diagnosed in 3 patients using the genetic test, while metachronous pancreatic cancer was diagnosed in 1 patient based on the long-term disease-free interval and histological findings.