Dataset Information

Total robotic surgery for pancreaticoduodenectomy combined with rectal cancer anterior resection: A case report and literature review.

ABSTRACT:

Rationale

Synchronous double malignancies, including carcinoma of the ampulla of Vater and rectal carcinoma, are generally uncommon occurrences in the gastrointestinal tract.

Patient concerns

The present study report a case of a 37-year-old man who was incidentally found to suffer from carcinoma of the ampulla of Vater and rectal carcinoma.

Diagnoses

The duodenoscopy was performed and revealed an ulcerated and bulky ampulla of Vater, the biopsy from which revealed a moderate-differentiated adenocarcinoma, A local hospital colonoscopy confirmed a tumor located in rectal 7?cm from the anal margin and biopsy-confirmed poorly differentiated adenocarcinoma.

Interventions

About such patient treatment, both open and laparoscopic surgery are restricted because of operation complexity, large injury, and poor cosmetic effect. surgery performed using Da Vinci robotic surgical system (DVSS).

Outcomes

No evidence of recurrence or relapses was found in the first year after surgery.

Lessons

Although sporadic double malignancies are uncommon, they should be considered when evaluating cancer patients. Complex surgery performed by robotic surgery may became surgeon's preferred treatment modality.

SUBMITTER: Jiang Q

PROVIDER: S-EPMC5959404 | biostudies-literature | 2018 May

REPOSITORIES: biostudies-literature

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Publications

Total robotic surgery for pancreaticoduodenectomy combined with rectal cancer anterior resection: A case report and literature review.

Jiang QunGuang Q Li TaiYuan T Liu DongNing D Tang Cheng C

Medicine 20180501 19

<h4>Rationale</h4>Synchronous double malignancies, including carcinoma of the ampulla of Vater and rectal carcinoma, are generally uncommon occurrences in the gastrointestinal tract.<h4>Patient concerns</h4>The present study report a case of a 37-year-old man who was incidentally found to suffer from carcinoma of the ampulla of Vater and rectal carcinoma.<h4>Diagnoses</h4>The duodenoscopy was performed and revealed an ulcerated and bulky ampulla of Vater, the biopsy from which revealed a moderat ...[more]

PMID: 29742689

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Project description:BackgroundHeterotopic ossification (HO) is the formation of osseous tissue outside the skeleton. HO in malignant tumors of the digestive tract is extremely rare, as is ossification in metastatic lesions from HO-negative digestive tract tumors. Regarding the pathogenesis of HO, two theories have been proposed. The first is that the osteoblastic metaplasia of tumor cells (driven by the epithelial-mesenchymal transition, EMT) results in HO, and the second is that factors secreted by cancer cells lead to the metaplasia of stromal pluripotent cells into osteoblasts. However, the osteogenic mechanisms remain unclear.Case presentationAn 83-year-old Japanese woman underwent low anterior rectal resection for rectal cancer before presentation at our institution, in June 2018. The final diagnosis was stage IIB rectal adenocarcinoma (T4aN0M0). Histological examination did not reveal HO in the primary tumor. Thirteen months after the operation, a solitary metastatic lesion in the brain 20?mm in size and a solitary metastatic lesion in a right axillary lymph node 20?mm in size were diagnosed. The patient was treated with gamma-knife therapy for the brain metastasis. One month later, she was referred to our institution. She underwent lymph node resection. Histological examination revealed that most portions of the affected lymph node were occupied by metastatic tumor cells and that central necrosis and four small ossified lesions without an osteoblast-like cell rim were present in the peripheral region. Immunohistochemical analysis showed tumor cells positive for BMP-2, osteonectin, osteocalcin, AE1/AE3, TGF-?1, Gli2, Smad2/3, and CDX2 and negative for nestin, CD56, and CK7.ConclusionThis is the first English case report of HO in a metachronous metastatic lymph node after the curative resection of HO-negative rectal cancer. Unlike HO lesions in past reports, the HO lesion did not show peripheral osteoblast-like cells, and the immunohistochemical findings indicated that the present case resulted from the EMT.

Dataset Information

Total robotic surgery for pancreaticoduodenectomy combined with rectal cancer anterior resection: A case report and literature review.

Rationale

Patient concerns

Diagnoses

Interventions

Outcomes

Lessons

Publications

Total robotic surgery for pancreaticoduodenectomy combined with rectal cancer anterior resection: A case report and literature review.

Similar Datasets

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