We report the case of a 56-year-old woman with pancreatic adenocarcinoma(PA) discovered during an episode of febrile jaundice. A computed tomography(CT) scan showed a mass in the head of the pancreas with circumferent...We report the case of a 56-year-old woman with pancreatic adenocarcinoma(PA) discovered during an episode of febrile jaundice. A computed tomography(CT) scan showed a mass in the head of the pancreas with circumferential infiltration of the superior mesenteric vein(SMV) and dilatation of the biliary and pancreatic ducts without metastases. The patient benefited from neoadjuvant chemotherapy(FOLFIRINOX) followed by radio-chemotherapy(45 Gy) and chemotherapy(LV5 FU2). The revaluation CT revealed SMV thrombosis without portal vein(PV) thrombosis. There was no contact of the tumor with the PV. Pancreatoduodenectomy with combined resection of the SMV was performed with no reconstruction of this venous axis after confirmation of adequate PV, splenic, and left gastric venous flow and the absence of bowel ischemia. The pathological diagnosis was p T4 N1 R0 PA. There were no bowel angina issues during the follow-up period. At 15 mo after surgery, the patient died of metastatic recurrence.展开更多
文摘We report the case of a 56-year-old woman with pancreatic adenocarcinoma(PA) discovered during an episode of febrile jaundice. A computed tomography(CT) scan showed a mass in the head of the pancreas with circumferential infiltration of the superior mesenteric vein(SMV) and dilatation of the biliary and pancreatic ducts without metastases. The patient benefited from neoadjuvant chemotherapy(FOLFIRINOX) followed by radio-chemotherapy(45 Gy) and chemotherapy(LV5 FU2). The revaluation CT revealed SMV thrombosis without portal vein(PV) thrombosis. There was no contact of the tumor with the PV. Pancreatoduodenectomy with combined resection of the SMV was performed with no reconstruction of this venous axis after confirmation of adequate PV, splenic, and left gastric venous flow and the absence of bowel ischemia. The pathological diagnosis was p T4 N1 R0 PA. There were no bowel angina issues during the follow-up period. At 15 mo after surgery, the patient died of metastatic recurrence.
