Rapidly growing adenosquamous carcinoma in the pancreatic tail discovered upon its resection for cervical tuberculous lymphadenitis: A case report

Hideo Ota, Hiromitsu Hoshino, Kyohei Ogisu,ryu Jokoji,Shinya Yamashita, Hirofumi Ikushima,Yoshifumi Arisaka, Hitoshi Mizuno

crossref(2024)

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摘要
Abstract Cancer (including pancreatic adenocarcinoma) can develop within one year of tuberculosis infection. However, it is unclear whether tuberculosis infection increases the risk of developing pancreatic adenosquamous carcinoma (ASCP), an extremely rare cancer with a poorer prognosis than pancreatic ductal adenocarcinoma (PDAC). Herein, we report a resected, rapidly growing adenosquamous carcinoma case of the pancreatic tail associated with cervical tuberculous lymphadenitis. The patient is a 57-year-old woman. An excisional biopsy of the swollen right cervical lymph nodes revealed tuberculous lymphadenitis. One month after the biopsy, an abdominal computed tomography scan showed a 2.0 cm (diameter) ischemic tumor in the pancreatic tail. The tissue obtained using endoscopic ultrasonography-guided fine-needle aspiration led to the pathological diagnosis of ASCP. Two months after the biopsy, the tumor had grown to 3.5 cm (diameter), and invasion of the stomach and colon was suspected. A distal pancreatectomy, splenectomy, partial gastrectomy, and transverse colectomy were performed. The final diagnosis was ASCP (4.7 cm, pT3, pN0, cM0, and p Stage IIA). Postoperative adjuvant combination chemotherapy combined with antituberculosis drugs was administered orally. We report the first case of a rapidly growing adenosquamous carcinoma resected from the pancreatic tail in association with cervical tuberculous lymphadenitis. Additional evidence is required to confirm that tuberculosis infection increases the risk of developing pancreatic adenosquamous cell carcinoma because its involvement in squamous cell metaplasia has not been proven. Patients with ASCP who underwent resection and adjuvant chemotherapy without early recurrence may have a 5-year survival rate similar to that of patients with PDAC.
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