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Numerous aberrant proliferative vessels from the duodenum were noted. The pathological diagnosis was T4bN0M0, Stage IIC, with a KRAS G12D mutation. He received four cycles of adjuvant chemotherapy. Four months later, a mass approximately 3\u00a0cm in diameter involving the duodenum and ileum was identified and diagnosed as localized recurrence with no evidence of distant metastasis. After administration of two cycles of chemotherapy, contrast-enhanced computed tomography demonstrated tumor shrinkage. A pancreaticoduodenectomy was performed, including resection of the involved ileum, and the short segment of transverse colon. Pathological examination revealed adenocarcinoma proliferation extending across the adhesion plane between the duodenum and ileum, infiltrating the muscularis propria of both intestinal walls without intraluminal exposure. These findings suggested that the tumor originated from residual cancer cells at the dissection plane of the initial surgery. No postoperative adjuvant chemotherapy was administered, in accordance with the patient\u2019s wishes. The patient has remained disease-free for more than 7\u00a0years after the pancreaticoduodenectomy.<\/jats:p>","DOI":"10.1007\/s12328-026-02420-2","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T12:32:01Z","timestamp":1786710721000},"page":"1169-1177","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Salvage pancreaticoduodenectomy for localized recurrence after resection of ascending colon cancer: a case report"],"prefix":"10.1007","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0137-9246","authenticated-orcid":false,"given":"Rihito","family":"Nagata","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1458-0689","authenticated-orcid":false,"given":"Nobuyuki","family":"Takemura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiko","family":"Komagome","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michio","family":"Kogure","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryosuke","family":"Satake","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3308-2455","authenticated-orcid":false,"given":"Natsuko","family":"Takayanagi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8496-568X","authenticated-orcid":false,"given":"Yasuhiro","family":"Nunokawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3910-9551","authenticated-orcid":false,"given":"Akira","family":"Maki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6894-7805","authenticated-orcid":false,"given":"Yoshifumi","family":"Beck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,14]]},"reference":[{"key":"2420_CR1","unstructured":"Network NCC. 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According to our institutional policy, ethics committee approval was not required for this type of report.","order":2,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The patient provided written informed consent for publication of this case report, including the presentation of relevant clinical and imaging data.","order":3,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This case report was conducted in accordance with the ethical standards of the Declaration of Helsinki. Institutional review board approval was waived because of the nature of this single-case report.","order":4,"name":"Ethics","label":"Human or animal rights","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Written informed consent was obtained from the patient.","order":5,"name":"Ethics","label":"Informed consent","group":{"name":"EthicsHeading","label":"Declarations"}}]}}