@entity788 frequently recurs in @entity1 even after resection with curative intent. The majority of these are early recurrences and are associated with @entity3 , thus not amenable to repeat resection. Here we report a @entity1 who underwent completion pancreatectomy for a metachronous @entity788 . This @entity1 initially presented with painless @entity1087 and computed tomography (CT) revealed a mass in the head of the pancreas. Brushings obtained at endoscopic retrograde cholangiopancreatography (ERCP) were positive for @entity420 . This @entity1 then underwent a Whipple procedure and final pathology demonstrated @entity788 . Adjuvant therapy included @entity136 and @entity3866 . This @entity1 was followed with physical examinations and serial laboratory and imaging studies. There was no evidence of disease for four years at which time and sharp elevation in CA-19-9 was found. Subsequent imaging revealed a mass in the remnant pancreas. Curative intent completion pancreatectomy was then performed which confirmed the presence of @entity788 . This was followed by adjuvant @entity136 based chemotherapy and chemoradiation. One year later the @entity1 is alive with no evidence of disease. Thus, in highly selected @entity1 with recurrent or metachronous @entity788 , repeat pancreatectomy can be considered, but the course of treatment should be considered in a multidisciplinary setting.

Resection of metachronous @entity788 4  years after pancreaticoduodenectomy for stage III XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity788 :: ('MESH:D010190', 'Disease') :: ['Pancreatic adenocarcinoma', 'pancreatic cancer', 'stage III pancreatic ductal adenocarcinoma', 'pancreatic adenocarcinoma'] @entity1087 :: ('MESH:D007565', 'Disease') :: ['jaundice'] @entity136 :: ('MESH:C056507', 'Chemical') :: ['Gemcitabine', 'gemcitabine'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastatic disease'] @entity420 :: ('MESH:D000230', 'Disease') :: ['adenocarcinoma'] @entity3866 :: ('MESH:C400278', 'Chemical') :: ['erlotinib']
@entity788 :: (MESH:D010190,Disease) :: ['pancreatic adenocarcinoma']
