A Case of Pancreatic Metastasis From Colorectal Cancer.

Tatsuzawa, Yasuhiko; Kurokawa, Mineo; Mochiki, Yutaka; Osawa, Takeshi; Nagashima, Kiyokazu; Yagi, Shingo; Fujioka, Shigeichi; Yamada, Tetsuji; Kitagawa, Susumu; Nakagawa, Masaaki

doi:10.5833/jjgs.34.132

Cited by 7 publications

(10 citation statements)

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“…The primary cancers that are most frequently responsible for pancreatic metastases are reportedly renal cell carcinoma (54.3–83.3%) and rectal cancer (7.5–16.7%) [2,9,12,20]. The median interval between resection of the primary cancer and development of pancreatic metastases is relatively longer, being reportedly 32.5–157 months [5,7–9,20].…”

Section: Discussionmentioning

confidence: 99%

“…Accurate preoperative diagnosis of pancreatic metastasis rather than a primary pancreatic cancer is difficult [7–10,12]. Cytological examination of a fine needle aspirate or pathological examination of a biopsy specimen obtained under endoscopic ultrasonography guidance is useful for preoperative diagnosis [4,8,9,20,21].…”

Section: Discussionmentioning

confidence: 99%

“…Pancreatic metastases from colorectal cancer are rare [3–14], and acceptable outcomes can be achieved by curative resection in carefully selected patients [5,6,8,10,12–15]. Treatment guidelines recommend aggressive resection of hematogenous metastases (i.e., lung or liver metastases) [16,17] if radiographic and/or surgical R0 (i.e., radiographic/surgical R0 resection, according to the Japanese Classification of Colorectal, Appendiceal and Anal carcinoma [18]) is accomplished [5,7–10,12,13,15–17]. Whether pancreatic metastases occur via hematogenous pathways is controversial [7–10,12].…”

Section: Introductionmentioning

confidence: 99%

“…Treatment guidelines recommend aggressive resection of hematogenous metastases (i.e., lung or liver metastases) [16,17] if radiographic and/or surgical R0 (i.e., radiographic/surgical R0 resection, according to the Japanese Classification of Colorectal, Appendiceal and Anal carcinoma [18]) is accomplished [5,7–10,12,13,15–17]. Whether pancreatic metastases occur via hematogenous pathways is controversial [7–10,12]. Aggressive surgery should be a component of multimodality treatment of metastatic colorectal cancer [5,6,8–10,12–17].…”

Section: Introductionmentioning

confidence: 99%

“…Whether pancreatic metastases occur via hematogenous pathways is controversial [7–10,12]. Aggressive surgery should be a component of multimodality treatment of metastatic colorectal cancer [5,6,8–10,12–17].…”

Section: Introductionmentioning

confidence: 99%

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Metachronous Pancreatic Metastasis from Rectal Cancer that Masqueraded as a Primary Pancreatic Cancer: A Rare and Difficult-to-Diagnose Metastatic Tumor in the Pancreas

et al. 2019

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Patient: Male, 70Final Diagnosis: Metachronous pancreatic metastasisSymptoms: NoneMedication: —Clinical Procedure: SurgerySpecialty: Gastroenterology and HepatologyObjective:Rare diseaseBackground:Pancreatic metastasis from colorectal cancer is rare and can masquerade as primary pancreatic cancer.Case Report:A 70-year-old male was diagnosed with advanced rectal cancer with multiple liver metastases. After neoadjuvant chemotherapy, he underwent radical surgery for the primary tumor and hepatectomy for multiple liver metastases. Adjuvant chemotherapies and additional surgeries were subsequently required for recurrences in the liver, lung, and lymph nodes. A diffuse hypovascular nodule in the pancreatic head and a solitary liver metastasis were detected 2.5 years after the initial surgery and he accordingly underwent further chemotherapy. However, the pancreatic tumor progressed, invading the pancreatic duct and biliary tract. Obstructive jaundice finally prompted discontinuation of chemotherapy and he underwent biliary drainage. His diffuse and hypovascular tumor was clinically and radiographically diagnosed as a primary pancreatic cancer. Pancreatic resection for the pancreatic tumor and hepatectomy for the liver metastasis were performed 4.2 years after the initial surgery, achieving radiographic and surgical curative resection. Pathological examination of the surgical specimen resulted in a definitive diagnosis of metachronous pancreatic metastasis from his primary rectal cancer. Despite further chemotherapy, his general condition worsened; however, he remains alive 5.4 years after the initial surgery, with best supportive care.Conclusions:Pancreatic metastasis originating from rectal cancer can masquerade as primary pancreatic cancer clinically and radiologically. Multimodality treatment is mandatory for metastatic colorectal cancer. Aggressive surgeries for pancreatic metastasis should be considered if curative resection appears possible radiographically and/or intraoperatively.

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