Surgery for colloid carcinoma of the pancreas with portal vein tumor thrombus: a case report

Abstract Background The portal vein is occasionally invaded by advanced malignant tumors in the pancreatic head region. However, pancreatic cancer rarely has portal vein tumor thrombi. We report a case of pancreatic cancer with a massive portal vein tumor thrombus undergoing pancreatoduodenectomy wi...

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Main Authors: Daisuke Udagawa, Motohide Shimazu, Tadayuki Sakuragawa, Shotaro Maruyama, Yusuke Uchi, Eisuke Miura, Yohei Masugi, Michiie Sakamoto
Format: Article
Language:English
Published: Japan Surgical Society 2020-10-01
Series:Surgical Case Reports
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Online Access:http://link.springer.com/article/10.1186/s40792-020-01025-2
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author Daisuke Udagawa
Motohide Shimazu
Tadayuki Sakuragawa
Shotaro Maruyama
Yusuke Uchi
Eisuke Miura
Yohei Masugi
Michiie Sakamoto
author_facet Daisuke Udagawa
Motohide Shimazu
Tadayuki Sakuragawa
Shotaro Maruyama
Yusuke Uchi
Eisuke Miura
Yohei Masugi
Michiie Sakamoto
author_sort Daisuke Udagawa
collection DOAJ
description Abstract Background The portal vein is occasionally invaded by advanced malignant tumors in the pancreatic head region. However, pancreatic cancer rarely has portal vein tumor thrombi. We report a case of pancreatic cancer with a massive portal vein tumor thrombus undergoing pancreatoduodenectomy with combined resection of the portal vein. Case presentation A 71-year-old man visited a clinic with complaints of abdominal discomfort and vomiting. Gastroscopy showed a massive tumor in the duodenum. He was referred to our hospital for further examinations and treatment. The CT showed a low-density tumor with a maximum diameter of 10 cm located on the pancreas head. A tumor widely invaded the duodenum and had a 6-cm portal vein tumor thrombus. MRCP did not show obvious stenosis of the pancreatic duct due to tumor invasion. There were no findings suggesting distant metastases. Biopsy of the duodenum revealed adenocarcinoma. He was diagnosed with primary pancreatic cancer or duodenal cancer with portal vein tumor thrombus and underwent pancreatoduodectomy with resection and reconstruction of the portal vein. He suffered no postoperative complications and was discharged 2 months after surgery. The final histopathological diagnosis was pancreatic colloid carcinoma. He received adjuvant chemotherapy, but died 16 months after surgery. Conclusions Colloid carcinoma of the pancreas is rare, and pancreatic carcinoma seldom forms a portal vein tumor thrombus. We experienced a very rare case of pancreatic colloid carcinoma with portal vein tumor thrombus and performed radical resection of the pancreas and portal vein.
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spelling doaj-art-2f69f12455a44b52a82d948ad7f4372f2025-08-20T02:37:28ZengJapan Surgical SocietySurgical Case Reports2198-77932020-10-01611610.1186/s40792-020-01025-2Surgery for colloid carcinoma of the pancreas with portal vein tumor thrombus: a case reportDaisuke Udagawa0Motohide Shimazu1Tadayuki Sakuragawa2Shotaro Maruyama3Yusuke Uchi4Eisuke Miura5Yohei Masugi6Michiie Sakamoto7Department of Surgery, Tama Kyuryo HospitalDepartment of Surgery, Tama Kyuryo HospitalDepartment of Surgery, Tama Kyuryo HospitalDepartment of Surgery, Tama Kyuryo HospitalDepartment of Surgery, Tama Kyuryo HospitalDepartment of Pathology, Keio University School of MedicineDepartment of Pathology, Keio University School of MedicineDepartment of Pathology, Keio University School of MedicineAbstract Background The portal vein is occasionally invaded by advanced malignant tumors in the pancreatic head region. However, pancreatic cancer rarely has portal vein tumor thrombi. We report a case of pancreatic cancer with a massive portal vein tumor thrombus undergoing pancreatoduodenectomy with combined resection of the portal vein. Case presentation A 71-year-old man visited a clinic with complaints of abdominal discomfort and vomiting. Gastroscopy showed a massive tumor in the duodenum. He was referred to our hospital for further examinations and treatment. The CT showed a low-density tumor with a maximum diameter of 10 cm located on the pancreas head. A tumor widely invaded the duodenum and had a 6-cm portal vein tumor thrombus. MRCP did not show obvious stenosis of the pancreatic duct due to tumor invasion. There were no findings suggesting distant metastases. Biopsy of the duodenum revealed adenocarcinoma. He was diagnosed with primary pancreatic cancer or duodenal cancer with portal vein tumor thrombus and underwent pancreatoduodectomy with resection and reconstruction of the portal vein. He suffered no postoperative complications and was discharged 2 months after surgery. The final histopathological diagnosis was pancreatic colloid carcinoma. He received adjuvant chemotherapy, but died 16 months after surgery. Conclusions Colloid carcinoma of the pancreas is rare, and pancreatic carcinoma seldom forms a portal vein tumor thrombus. We experienced a very rare case of pancreatic colloid carcinoma with portal vein tumor thrombus and performed radical resection of the pancreas and portal vein.http://link.springer.com/article/10.1186/s40792-020-01025-2Portal vein tumor thrombusPancreatic colloid carcinomaPancreatoduodenectomyResection of the portal vein
spellingShingle Daisuke Udagawa
Motohide Shimazu
Tadayuki Sakuragawa
Shotaro Maruyama
Yusuke Uchi
Eisuke Miura
Yohei Masugi
Michiie Sakamoto
Surgery for colloid carcinoma of the pancreas with portal vein tumor thrombus: a case report
Surgical Case Reports
Portal vein tumor thrombus
Pancreatic colloid carcinoma
Pancreatoduodenectomy
Resection of the portal vein
title Surgery for colloid carcinoma of the pancreas with portal vein tumor thrombus: a case report
title_full Surgery for colloid carcinoma of the pancreas with portal vein tumor thrombus: a case report
title_fullStr Surgery for colloid carcinoma of the pancreas with portal vein tumor thrombus: a case report
title_full_unstemmed Surgery for colloid carcinoma of the pancreas with portal vein tumor thrombus: a case report
title_short Surgery for colloid carcinoma of the pancreas with portal vein tumor thrombus: a case report
title_sort surgery for colloid carcinoma of the pancreas with portal vein tumor thrombus a case report
topic Portal vein tumor thrombus
Pancreatic colloid carcinoma
Pancreatoduodenectomy
Resection of the portal vein
url http://link.springer.com/article/10.1186/s40792-020-01025-2
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