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Laparoscopic-assisted distal gastrectomy and central pancreatectomy for gastric and perigastric lymph node metastases and pancreatic invasion from melanoma : a case report

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Title: Laparoscopic-assisted distal gastrectomy and central pancreatectomy for gastric and perigastric lymph node metastases and pancreatic invasion from melanoma : a case report
Authors: Okawa, Yuki Browse this author
Ebihara, Yuma Browse this author →KAKEN DB
Tanaka, Kimitaka Browse this author →KAKEN DB
Nakanishi, Yoshitsugu Browse this author →KAKEN DB
Asano, Toshimichi Browse this author →KAKEN DB
Noji, Takehiro Browse this author →KAKEN DB
Kurashima, Yo Browse this author →KAKEN DB
Murakami, Soichi Browse this author →KAKEN DB
Nakamura, Toru Browse this author →KAKEN DB
Tsuchikawa, Takahiro Browse this author →KAKEN DB
Okamura, Keisuke Browse this author →KAKEN DB
Shichinohe, Toshiaki Browse this author →KAKEN DB
Hirano, Satoshi Browse this author →KAKEN DB
Keywords: Malignant melanoma
Central pancreatectomy
Laparoscopic distal gastrectomy
Issue Date: 29-Sep-2020
Publisher: Springer
Journal Title: Surgical case reports
Volume: 6
Issue: 1
Start Page: 239
Publisher DOI: 10.1186/s40792-020-01027-0
Abstract: Background In melanoma, completely resectable metastases are surgically resected to expect to prolong relapse-free survival and overall survival. However, distant metastases of melanoma are rarely indicated for surgery because multiple metastases are often observed at diagnosis. We report a case of a man in his 50s who underwent laparoscopic-assisted distal gastrectomy and central pancreatectomy for gastric metastases, lymph node metastases, and pancreatic invasion that could be completely resected. Case presentation A 50-year-old man was diagnosed with malignant melanoma of the left parietal region. After diagnosis, tumor resection and left cervical lymph node dissection were performed, and interferon-beta treatment was added as adjuvant therapy. Seventeen months after adjuvant therapy, metastasis of stomach and abdominal lymph nodes from melanoma was diagnosed. And the pancreatic invasion of lymph nodes was suspected. Laparoscopic-assisted distal gastrectomy and the central pancreatectomy were performed because pancreatic invasion of melanoma was intraoperatively found. After 9 months of relapse-free survival, abdominal recurrence was observed. Nivolumab and ipilimumab were administered, and recurrent lesions are currently controlled. The patient has survived more than 3 years since metastasis resection. Conclusion In conclusion, laparoscopic-assisted distal gastrectomy and the central pancreatectomy were performed for gastric and perigastric lymph node metastases and pancreatic invasion due to malignant melanoma, and the negative surgical margin was achieved. Although patient selection is required, the central pancreatectomy was a good indication for maintaining exocrine and endocrine function. The development of immune checkpoint inhibitors and molecular-targeted agents may increase gastrointestinal surgery for metastatic melanoma in the future.
Rights: http://creativecommons.org/licenses/by/4.0/
Type: article
URI: http://hdl.handle.net/2115/79759
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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