Locally Invasive Pancreatic Adenocarcinoma Presenting in the Splenic Flexure: A Rare Case Report

Ekanayake, Lakmal S; Jenkins, David; Swade, Stephen; Patel, Harsh; Bruce, David S.

doi:10.7759/cureus.8085

Cited by 3 publications

(3 citation statements)

References 9 publications

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“…We found a total of 21 case reports of pancreatic cancer presenting as GIB in the past 20 years (Table 1). [1,[4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] By summarizing the literature, we think pancreatic cancer presenting as GIB has several mechanisms: 1. The tumor directly Higashiyama et al [17] 69/- invades gastrointestinal tract, such as the stomach, duodenum, and colon; 2.…”

Section: Discussionmentioning

confidence: 99%

Pancreatic head cancer with gastrointestinal bleeding as the initial manifestation: a case report and literature review

Zheng

Niu

et al. 2023

Journal of Pancreatology

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Gastrointestinal bleeding (GIB) as the initial symptom is rare in patients with pancreatic cancer, which is prone to misdiagnosis and should be paid attention to by clinicians. Here, we present a patient with pancreatic head cancer whose first symptom was only severe upper gastrointestinal bleeding, which initially led to misdiagnosis. However, subsequent imaging revealed a mass in the pancreatic head which was considered a malignant tumor. After surgical resection, the pathology confirmed that the mass in the pancreatic head was pancreatic ductal adenocarcinoma, and the duodenal bulb’s full thickness was infiltrated. A literature review found that pancreatic cancer can present gastrointestinal bleeding by invading the digestive tract and blood vessels, left-sided portal hypertension (LSPH), digestive tract metastasis, and canceration of ectopic pancreatic tissue in the digestive tract. For these cases, clinicians should utilize multidisciplinary diagnosis and treatment based on digestive endoscopy, imaging, interventional therapy, and surgery to control bleeding, identify etiology, and remove tumors.

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Section: Discussionmentioning

confidence: 99%

Pancreatic head cancer with gastrointestinal bleeding as the initial manifestation: a case report and literature review

Zheng

Niu

et al. 2023

Journal of Pancreatology

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“…Pathology demonstrated pancreatic ductal adenocarcinoma with extension into wall of the splenic flexure. It was noted that the patient's CA19-9 was elevated and the carcinoma invaded the peripancreatic soft tissue [6] .…”

Section: Discussionmentioning

confidence: 99%

Pancreatic cancer presenting as bowel obstruction and role of next generation sequencing: A case report

Ardalan

Azqueta

England

et al. 2022

International Journal of Surgery Case Reports

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Introduction and importance Pancreatic adenocarcinoma is one of the leading causes of death. Presentation with colonic metastases is far less frequently reported in the literature and may be misdiagnosed as colonic adenocarcinoma. We report the case of a female patient with metastatic pancreatic adenocarcinoma that presented with a sigmoid obstruction. Case presentation A 66-year-old female presented with constipation and abdominal pain. She was found to have an obstructing sigmoid colon lesion, multiple metastatic lesions in the liver, and a pancreatic tail lesion. She underwent left hemicolectomy and ostomy placement. The gross pathology of the colon and needle biopsy of the liver was consistent of pancreatobiliary origin. Genomic screening performed, patient found to be KRAS G12R mutated. She was given one cycle of chemotherapy, thereafter was referred to hospice care. Clinical discussion Primary metastatic pancreatic cancer is now the 2nd most diagnosed cancer in the United States after lung cancer. The prognosis for the malignancy is poor, patients are usually diagnosed late at the time that the tumor has metastasized to other organs. Colonic metastasis is a rarely seen and far less frequently reported in the literature. Next-generation-sequencing was performed at baseline to further characterize her tumor for any actionable mutations. Conclusion Pancreatic adenocarcinoma is an aggressive malignancy with a poor prognosis. Next-generation-sequencing may offer targeted therapy if an actionable mutation is present such as our patient's, however due to late diagnosis, rapid clinical deterioration, and next-generation sequencing delay we were unable to alter the patient's outcome.

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“…Pathology demonstrated pancreatic ductal adenocarcinoma with extension into wall of the splenic flexure. It was noted that the patient's CA19-9 was elevated, and the carcinoma invaded the peripancreatic soft tissue 10 .…”

Section: Introductionmentioning

confidence: 99%

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2022

J Cancer Treatment Diagn

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Locally Invasive Pancreatic Adenocarcinoma Presenting in the Splenic Flexure: A Rare Case Report

Cited by 3 publications

References 9 publications

Pancreatic head cancer with gastrointestinal bleeding as the initial manifestation: a case report and literature review

Pancreatic head cancer with gastrointestinal bleeding as the initial manifestation: a case report and literature review

Pancreatic cancer presenting as bowel obstruction and role of next generation sequencing: A case report

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