Pancreatic Adenocarcinoma in a Pregnant Patient with Situs Inversus: a Case Report

Bekkhan Khatsiev, MD, PhD; Enver Baichorov, MD, ScD; Alexander Kuzminov, MD*

The Stavropol State Medical University; Stavropol, Russian Federation.

*Corresponding author: Alexander Kuzminov, MD. Clinic endoscopic and minimally invasive surgery of the Stavropol State Medical University. E-mail: dr.kuzminov@gmail.com

Published: June 22, 2014.

Abstract: 

This is a report on the case of pancreatic adenocarcinoma in 29-year-old pregnant woman with situs inversus. The main consideration was whether pregnancy should be preserved. Patient underwent pancreatoduodenectomy following pregnancy, abortion, and mastectomy for breast adenoma. Whipple pancreatoduodenectomy with open pancreaticogastrostomy was performed. Microscopy revealed clear cell adenocarcinoma with low-grade differentiation, which was confirmed by an immunohistochemical study. Patient feels good, without any signs of pain or decrease in life quality, four years after the operation. We think that such complex cases require the application of every available diagnostic method and that surgery should be performed by the most experienced surgeon.

Keywords: 
pancreatic cancer; pregnancy; pancreatoduodenectomy.
References: 

1. He J, Edil BH, Cameron JL, Schulick RD, Hruban RH, Herman JM, et al. Young patients undergoing resection of pancreatic cancer fare better than their older counterparts. J Gastrointest Surg 2013;17(2):339-44.

2. Blackbourne LH, Jones RS, Catalano CJ, Iezzoni JC, Bourgeois FJ. Pancreatic adenocarcinoma in the pregnant patient: case report and review of the literature. Cancer 1997; 79(9):1776-9.

3. Kakoza RM, Vollmer CM, Jr., Stuart KE, Takoudes T, Hanto DW. Pancreatic adenocarcinoma in the pregnant patient: a case report and literature review. J Gastrointest Surg 2009; 13(3):535-41.

4. Marci R, Pansini G, Zavatta C, Mossuto E, Giugliano E, Marzola M, et al. Pancreatic cancer with liver metastases in a pregnant patient: case report and review of the literature. Clin Exp Obstet Gynecol 2012; 39(1):127-30.

5. Papoutsis D, Sindos M, Papantoniou N, Antsaklis A. Management options and prognosis of pancreatic adenocarcinoma at 16 weeks' gestation: a case report. J Reprod Med 2012; 57(3-4):167-70.

6. Maruyama Y, Horiuchi H, Okabe Y, Kawahara R, Uchida S, Sakai T, et al. Perioperative challenges associated with a pancreaticoduodenectomy and distal pancreatectomy for pancreatic cancer in patients with situs inversus totalis: report of two cases. Surg Today 2010; 40(1):79-82.

7. Quintini C, Buniva P, Farinetti A, Monni S, Tazzioli G, Saviano L, et al. Adenocarcinoma of pancreas with situs viscerum inversus totalis. Minerva Chir 2003; 58(2):243-6.

8. Sceusi EL, Wray CJ. Pancreatic adenocarcinoma in a patient with situs inversus: a case report of this rare coincidence. World J Surg Oncol 2009; 7:98.

9. Lazarus E, Debenedectis C, North D, Spencer PK, Mayo-Smith WW. Utilization of imaging in pregnant patients: 10-year review of 5270 examinations in 3285 patients--1997-2006. Radiology 2009; 251(2):517-24.

10. Mayo JR. Radiation dose issues in longitudinal studies involving computed tomography. Proc Am Thorac Soc 2008; 5(9):934-9.

11. Sohn TA, Yeo CJ, Cameron JL, Koniaris L, Kaushal S, Abrams RA, et al. Resected adenocarcinoma of the pancreas - 616 patients: results, outcomes, and prognostic indicators. J Gastrointest Surg 2000; 4(6):567-79.

The fully formatted PDF version is available.

Download Article

Int J Biomed. 2014; 4(2):107-108. © 2014 International Medical Research and Development Corporation. All rights reserved.