Nicolae Bacalbasa1,2,3, Adina Croitoru3,4, Iulian Brezean1,2, Irina Balescu5, Mihaela Vilcu1,2, Simona Dima3, Vladislav Brasoveanu3,4, Irinel Popescu3,4. 1. Carol Davila University of Medicine and Pharmacy, Bucharest, Romania. 2. I. Cantacuzino Clinical Hospital, Bucharest, Romania. 3. Fundeni Clinical Institute - Center of Excellence in Translational Medicine, Bucharest, Romania. 4. Titu Maiorescu University of Medicine and Pharmacy, Bucharest, Romania. 5. Ponderas Academic Hospital, Bucharest, Romania irina.balescu@ponderas-ah.ro.
Abstract
BACKGROUND/AIM: Locally advanced pancreatic head cancer remains an aggressive malignancy with a low likelihood of achieving resectability after neoadjuvant chemotherapy. Resection is even more difficult if anatomical variations of the blood supply are present. CASE REPORT: We present the case of a 62-year-old male diagnosed with locally advanced pancreatic cancer in the presence of an aberrant right hepatic artery originating from the superior mesenteric artery. After completing six cycles of neoadjuvant chemotherapy consisting of irinotecan and oxaliplatin, resectability was achieved, the patient being submitted to pancreatoduodenectomy. Intraoperatively, the presence of an aberrant right hepatic artery originating from the superior mesenteric artery was confirmed. The postoperative course was uneventful, the patient being discharged on the eight postoperative day, while the histopathological studies confirmed the negativity of the resection margins. CONCLUSION: Resectability can be achieved after neoadjuvant chemotherapy for locally advanced pancreatic cancer. However, attention should be focused on the possibility of the presence of anatomical variations of the pancreatic and liver blood supply. Copyright
BACKGROUND/AIM: Locally advanced pancreatic head cancer remains an aggressive malignancy with a low likelihood of achieving resectability after neoadjuvant chemotherapy. Resection is even more difficult if anatomical variations of the blood supply are present. CASE REPORT: We present the case of a 62-year-old male diagnosed with locally advanced pancreatic cancer in the presence of an aberrant right hepatic artery originating from the superior mesenteric artery. After completing six cycles of neoadjuvant chemotherapy consisting of irinotecan and oxaliplatin, resectability was achieved, the patient being submitted to pancreatoduodenectomy. Intraoperatively, the presence of an aberrant right hepatic artery originating from the superior mesenteric artery was confirmed. The postoperative course was uneventful, the patient being discharged on the eight postoperative day, while the histopathological studies confirmed the negativity of the resection margins. CONCLUSION: Resectability can be achieved after neoadjuvant chemotherapy for locally advanced pancreatic cancer. However, attention should be focused on the possibility of the presence of anatomical variations of the pancreatic and liver blood supply. Copyright
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