[A case of surgical treatment of solitary liver metastasis from pancreatic cancer].

We report a 50-year-old female with pancreatic cancer invading the duodenum. In December 2006, the patient underwent the pancreatoduodenectomy with portal vein resection. Histological examination demonstrated a poorly differentiated ductal carcinoma fT4N2M0, fStage IVb. The postoperative irradiation to pancreatic bed was performed one month after surgery, followed by an adjuvant chemotherapy using gemcitabine. Eight months post operation, CT examination showed liver and lung metastases, resulting in conversion of the drug to S-1. S-1 administration was withdrawn because of grade 3 vomiting. Paclitaxel was selected as the third-line. However, febrile neutrophenia and septic shock were emerged during the first course and recovered by the cause intensive care. CT revealed disappearance of recurrence during 7 months without any chemotherapy. Thereafter, the solitary liver metastasis reappeared without any other hot spot on PET. Resection of liver metastasis resulted in survival of 29 months after pancreactomy, and 8 months after liver resection.