CASE REPORT   

Chirurgia 2019 June;32(3):137-42

DOI: 10.23736/S0394-9508.18.04824-6

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

Disease-free long survival after stump recurrence and reoperation of pancreatic IPMN with invasive carcinoma

Emanuele SANTORO ¹, Paolo VISCA ², Roberto SANTORO ^{1, 2}, Pietro MANCINI ³, Eugenio SANTORO ^{1, 2, 3, 4} ✉

¹ San Camillo City Hospital, Rome, Italy; ² Cancer Institute Regina Elena, Rome, Italy; ³ Cristo Re City Hospital, Rome, Italy; ⁴ Policlinico Portuense Luigi Di Liegro, Rome, Italy

Reoperation on malignant tumors of the pancreatic stump remaining from a previous resection for cancer is very rare. The literature reports few cases in which the tumors were mostly made up of intraductal papillary mucinous neoplasm (IPMN) sometimes associated with invasive carcinoma or adenocarcinoma (PDAC). One of those rare cases has come to our attention: a 62-year-old man, anicteric, with a massive tumor of the head of the pancreas 11x7x5, subjected to DCP for IPMN-MD with isolated areas of invasive cancer, misinterpreted at the beginning as PDAC. Nine years later, with markers remaining negative, it was reoperated on a total Pancreatectomy for recurrence of the same cancer of the pancreatic stump, despite negative lymph nodes. 15 years after the first surgery and 6 years after the second operation the patient is alive, healthy, diabetic, but disease free. The case is an opportunity to discuss the biological, epidemiological, therapeutic and prognostic differences between invasive carcinoma, developed on intraductal papillary mucinous tumors, and tubular primitive pancreatic adenocarcinoma.

KEY WORDS: Pancreatic neoplasms - Adenocarcinoma - Recurrence - Reoperation