Widespread lymph node recurrence of major duodenal papilla cancer following pancreaticoduodenectomy

Figure 1 Computed tomography images of the recurrent lymph node metastases (red arrows). A-C: At the time of recurrence (A: Cervical region; B: Mediastinal region; C: Retroperitoneal region); D-F: Images taken 1.5 mo after chemoradiotherapy (D: Cervical region; E: Mediastinal region; F: Retroperitoneal region); G-I: Images taken 2 years after treatment (G: Cervical region; H: Mediastinal region; I: Retroperitoneal region). The recurrent lymph nodes dramatically decreased in size 1.5 mo after treatment, and nearly disappeared 2 years after treatment.

Figure 2 Positron emission tomography/computed tomography images of the patient. A: Before treatment; B: Two years after chemoradiotherapy.

Figure 3 Initial radiation treatment plan showing isodose distribution images of the body. A: Bilateral cervical area; B: Bilateral supraclavicular area; C: Mediastinal area; D: Retroperitoneal area.