Pancreatoduodenectomy following neoadjuvant chemotherapy in duodenal adenocarcinoma.
Dongjin SeoBo Gyeom ParkDawn JungHo Kyoung HwangChang Moo KangSeung-Soo HongChang Moo KangPublished in: Annals of hepato-biliary-pancreatic surgery (2022)
A 51-year-old male patient had four times of massive hematochezia episode three days before arrival. Carbohydrate antigen (CA) 19-9 level was extremely elevated. Computed tomography, magnetic resonance imaging, and positron emission tomography-computed tomography identified 5.7 cm sized periampullary duodenal cancer with regional metastatic lymph nodes and vascular invasion to aberrant right hepatic artery, main portal vein, and superior mesenteric vein. Diagnosed as duodenal adenocarcinoma through endoscopic biopsy, 16 times of FOLFIRI (5-fluorouracil, leucovorin, irinotecan) was conducted. The regimen changed to XELOX (capecitabine, oxaliplatine), four times of administration was done, and the CA19-9 level dramatically decreased. The tumor decreased to 2.1 cm. After R0 laparoscopic pylorus preserving pancreatoduodenectomy, no adjuvant therapy was given. No sign of recurrence or metastasis was reported, and the patient reached complete remission after five years. We reported a case where neoadjuvant chemotherapy for locally advanced duodenal adenocarcinoma was shown to be effective.
Keyphrases
- neoadjuvant chemotherapy
- locally advanced
- computed tomography
- positron emission tomography
- squamous cell carcinoma
- lymph node
- magnetic resonance imaging
- rectal cancer
- phase ii study
- sentinel lymph node
- radiation therapy
- case report
- contrast enhanced
- dual energy
- ultrasound guided
- papillary thyroid
- image quality
- small cell lung cancer
- lymph node metastasis
- pet ct
- magnetic resonance
- cell migration
- randomized controlled trial
- robot assisted
- systemic lupus erythematosus
- disease activity
- fine needle aspiration
- minimally invasive