Journal of Digestive Cancer Research

Korean Society of Gastrointestinal Cancer Research (대한소화기암연구학회)
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A Case of Pancreatic Cancer Recurred in Liver after Surgical Resection, in Complete Response after Chemotherapy and Tumorectomy

수술적 절제술 후 간에 재발한 췌장암에서 항암화학요법과 종양절제술로 완전 관해를 보인 증례

  • Jun Hyuk Son (Department of Internal Medicine and Liver Research institute, Seoul National University Hospital) ;
  • Jae Woo Lee (Department of Internal Medicine and Liver Research institute, Seoul National University Hospital) ;
  • Dong Kee Jang (Department of Internal Medicine and Liver Research institute, Seoul National University Hospital) ;
  • Sang Hyub Lee (Department of Internal Medicine and Liver Research institute, Seoul National University Hospital) ;
  • Ji Kon Ryu (Department of Internal Medicine and Liver Research institute, Seoul National University Hospital) ;
  • Yong-Tae Kim (Department of Internal Medicine and Liver Research institute, Seoul National University Hospital)
  • 손준혁 (서울대학교 의과대학 내과학교실, 간연구소) ;
  • 이재우 (서울대학교 의과대학 내과학교실, 간연구소) ;
  • 장동기 (서울대학교 의과대학 내과학교실, 간연구소) ;
  • 이상협 (서울대학교 의과대학 내과학교실, 간연구소) ;
  • 류지곤 (서울대학교 의과대학 내과학교실, 간연구소) ;
  • 김용태 (서울대학교 의과대학 내과학교실, 간연구소)
  • Received : 2015.11.21
  • Accepted : 2015.12.18
  • Published : 2015.12.31
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Abstract

Pancreatic cancer is commonly presented with distant metastasis. However metastasis to central nervous system (CNS) of pancreatic cancer was rarely reported. 79-years-old man was hospitalized with sudden onset right arm dysesthesia and weakness. In brain magnetic resonance imaging, multifocal high signal intensity lesions in cerebral and cerebellar cortices were observed. Leptomeningeal and parenchymal enhanced lesions were also noted in contrast-enhanced T1 images suggesting a metastasis from the pancreatic cancer. Stroke like manifestation of CNS metastasis of pancreatic cancer is extremely rare. Careful history taking and evaluation should be performed to find the origin of the sudden neurologic deficit.

췌장암은 예후가 매우 불량한 암으로 수술적 절제술을 시행하여도 대부분의 경우 재발을 한다고 알려져 있다. 재발을 하는 경우 대개 항암화학요법을 시행하게 되나, 그 반응 또한 좋지 않은 것으로 알려져 있다. 간에 국소적으로 재발을 했을 경우 종양절제술을 시행하는 것에 대해서는 몇몇 보고가 있는 정도이며, 생존율을 향상시킬 수 있는지에 대해서는 연구가 거의 없는 상태이다. 본 증례는 유문보존 췌십이지장 절제술 시행 후 간에 국소적으로 재발한 췌장암에 대하여 gemcitabine 및 capecitabine과 oxaliplatin 병합 항암화학요법을 시행하였으나 크기가 증가하였고, 이에 종양절제술을 시행하였으며, 이후 장기생존을 보였던 경우로 매우 드문 증례를 경험하였기에 보고하는 바이다.

Keywords

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