Late nodal recurrence after two curative resections for microinvasive intraductal papillary mucinous carcinoma: A case report

Figure 5 Clinical course and tumor marker trends. The patient’s clinical course is described below. Serum tumor marker levels (carbohydrate antigen 19-9, duodenal pancreatic cancer antigen-2, and S-pancreas antigen-1) are plotted as line graphs. Major clinical events, including surgery and hospitalization for cholangitis, are indicated. Thirteen years after the second surgery, marked elevation of tumor markers was observed at the time of lymph node recurrence adjacent to the superior mesenteric artery. Following 9 months of alternate-day oral administration of S-1, all tumor marker levels returned to within normal ranges. CA19-9: Carbohydrate antigen 19-9; DUPAN-2: Duodenal pancreatic cancer antigen-2; Span-1: S-pancreas antigen-1.