Background: Isolated local recurrence after surgical resection for pancreatic cancer is rare. Current common therapies for recurrence include chemotherapy or chemoradiation. There are few, if any, reports regarding surgical resection of local pancreatic cancer recurrence. This is the first report of using irreversible electroporation (IRE) to treat a pancreatic adenocarcinoma local recurrence and represents a true 5-year survivor and possible cure.
Case report: A 50-year-old female initially presented with 2.5 cm mass in the uncinate process of the pancreas suspicious for malignancy. Preoperative endoscopic guided fine needle aspirate (FNA) confirmed adenocarcinoma. She underwent pylorus preserving pancreaticoduodenectomy with the finding of stage II pancreatic cancer with complete resection after neoadjuvant chemotherapy. One year later she developed recurrent abdominal pain and restaging scans confirmed a new 2.5 cm lesion in the retroperitoneum. Positron emission tomography (PET) scan confirmed local recurrence. No metastatic disease was identified. She subsequently underwent chemotherapy and radiation therapy with persistent mass lesion present. After a period of stability, she was taken for laparotomy with IRE of the entire retroperitoneal tumor, followed by adjuvant chemotherapy. She has been closely monitored with computed tomography (CT) scans and tumor markers. Her most recent scan confirmed complete resolution of the lesion. She is now over 6 years from pancreaticoduodenectomy with no additional signs of pancreatic cancer recurrence.
Conclusions: Patients with isolated recurrent pancreatic cancer are uncommon and have limited treatment options. IRE is currently used for locally-advanced, unresectable pancreatic cancer with promising results. This case serves as an example that IRE can contribute to enhanced long term survival for patients with pancreatic adenocarcinoma, including those with isolated local recurrence.
Tuttle, R. N.,
& Ouellette, J. R.
(2017). Irreversible Electroporation of Locally Recurrent Pancreatic Cancer with 5-Year Survival. Liver and Pancreatic Sciences, 2 (2), 1-4.