Duodenal Hemorrhage from Pancreatic Cancer Infiltration Controlled through Combination Therapy with Gemcitabine and S-1

Abstract

2.6% of pancreatic cancer patients have the primary manifestation of gastrointestinal bleeding. It is not feasible to stop the duodenal hemorrhage caused by the pancreatic cancer infiltration. A 43-year-old woman who was diagnosed as having pancreatic cancer with multiple hepatic metastases and duodenal infiltration was administered gemcitabine and S-1 combination therapy. During the chemotherapy, initially, bleeding occurred due to duodenal infiltration. However, we continued the chemotherapy and duodenal infiltration was markedly reduced in size and did not rebleed. Aggressive chemotherapy contributed to maintenance of performance status as well as improvement of quality of life for the patient.

Transcatheter arterial embolization for upper gastrointestinal tract bleeding.

“…Bleeding, as a symptom of pancreatic cancer, occurs in 2.6% of pancreatic cancer patients [ 40 ]. Although rare, once pancreatic tumor bleeding has occurred, it often repeats and causes major blood loss [ 41 ]. This is evident in our data, as two of the three patients with bleeding due to pancreatic cancer had repeated bleeding.…”

Pancreaticobiliary Malignancies in the Emergency Room: Management of Acute Complications and Oncological Emergencies

“…TAE is more appropriate for arterial embolisation, while surgical hemostasis may increase complications and does not improve the prognosis [58]. Radiotherapy in case of endoscopic haemostasis failure can be an effective option [59,60]. The evidence for the use of tranexamic acid in the control of GI bleeding is limited [61], while its role in PB cancers is unclear.…”

Development and evaluation of new approaches for fluorescence-guided surgery and therapy of pancreatic ductal adenocarcinoma using orthotopic mouse models

“…A comparison of these studies with the data obtained here is very difficult, due to the different amount of tumor cells transplanted and to the different transplantation sites performed by others. For example, here, transplantation of 1x10 6 cells into the more proximal (head) part of the pancreas was performed, obtaining in all models a structured tumor mass in an adequate period of time. By comparison, Hotz and colleagues transplanted a much higher number of AsPC-1, Capan-1 and MIA PaCa-2 tumor cells (1x10 7 ) into the tail of the pancreas [24].…”

“…PDAC is the fourth leading cause of cancer death in men and women in western societies, with a 5-year survival rate of less than 5% [5]. This extremely poor prognosis is largely attributed to its propensity for early local infiltration into surrounding organs including stomach and duodenum, to peritoneal metastases into the liver and spleen and distant metastases into the lymphatic system and lungs [6][7][8]. The most common symptoms of PDAC include abdominal pain, weight loss, digestive problems and chronic fatigue, whereas jaundice is the most common clinical sign.…”

“…different PDAC mouse models were established by orthotopic implantation of 1 x 106 human pancreatic tumor cells into the head of the pancreas of athymic male nude mice.Because human pancreatic cancer includes a multitude of histomorphological subgroups, AsPC-1, MIA PaCa-2 and PANC-1 cell lines as undifferentiated-or poorly differentiated-, BxPC-3 as moderately differentiated-and Capan-1 as differentiated cell lines were chosen to be applied.Orthotopic transplantation into the head of the pancreas of all five human PDAC cell lines resulted in local tumor growth and in most cases in tumor invasion into the duodenum and stomach. However, in each PDAC mouse model, depending on the cell line implanted, a distinct pattern of tumor growth and progression occurred.…”