S-1 Induced Discoid Lupus Erythematosus-Like Lesions and Long-Term Complete Response for Para-Aortic Lymph Node Recurrence of Pancreatic Ductal Adenocarcinoma: A Case Report

    June 2018 in “ Surgical Case Reports ”
    Ryosuke Yamaga, Koji Tezuka, Shuichiro Sugawara, Toshihiro Watanabe, Ichiro Hirai, Tamio Suzuki, Wataru Kimura
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    TLDR S-1 treatment led to a complete response in pancreatic cancer with manageable side effects.
    In 2018, a 65-year-old Japanese man with recurrent pancreatic ductal adenocarcinoma experienced a complete response to S-1 monotherapy, despite developing discoid lupus erythematosus (DLE)-like skin lesions. The patient's CA19-9 levels decreased and the lymph node metastasis shrank within the first month of treatment. He continued the therapy at a reduced dose for 41 months, with medical management of the skin lesions, and remained free of recurrence or metastasis for 113 months post-surgery. The case highlighted the potential for S-1 therapy to be effective even with DLE-like lesions, provided that the dosage is managed and skin lesions are treated. The patient also developed mesangial proliferative glomerulonephritis, possibly related to S-1. Regular monitoring of proteinuria and renal function was recommended for patients with DLE-like drug eruptions during S-1 treatment.
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