[A Case of Pancreatic Intraductal Papillary Mucinous Adenocarcinoma with Disseminated Recurrence Successfully Treated...

An 86-year-old male underwent laparoscopic distal pancreatectomy for intraductal papillary mucinous carcinoma(IPMC). Pathological examination revealed pT3N1aM0, pStage Ⅱb. One year post-surgery, tumor markers elevated, and CT showed a soft tissue in the left anterior pararenal space. Suspecting lymph node metastasis or peritoneal dissemination recurrence of IPMC, a nodule localized in the left upper abdomen was excised laparoscopically. Pathological examination confirmed recurrence of IPMC with peritoneal dissemination, infiltrating the co-resected stomach. Chemotherapy with gemcitabine alone was initiated, and after 2 courses, tumor markers decreased, and no signs of recurrence were observed on CT. Though there are reported cases where resection has shown therapeutic effects for disseminated pancreatic cancer recurrence, high-quality evidence is lacking. In this case, surgery was performed for both diagnosis and treatment, and the disseminated nodule was localized, allowing for resection without excessive invasiveness. Given the possibility of future recurrent lesions, chemotherapy is also being administered. This case suggests that local resection for disseminated pancreatic cancer recurrence may be effective as part of multimodal treatment, but further case accumulation is necessary to establish a treatment strategy.