Long-term survival after repeated resection for lung metastasis originating from pancreatic cancer: a case report

Abstract

Background: Pancreatic cancer has a grave prognosis. Most patients with metastatic pancreatic cancer are inoperable, and case reports of resection of lung metastasis from pancreatic cancer are rare. This patient underwent resection of a lung metastasis twice after pancreaticoduodenectomy for pancreatic cancer. Case presentation: A 75-year-old man with pancreaticoduodenectomy and adjuvant chemotherapy for pancreatic cancer was diagnosed with a lung metastasis 48 months after surgery. Histological findings after thoracoscopic partial resection of the right lung by video-assisted thoracic surgery confirmed the presence of a lung metastasis originating from the pancreatic cancer. The patient refused chemotherapy. A new lung metastasis was detected 84 months following the second surgery (132 months after the pancreaticoduodenectomy). After thoracoscopic partial resection of the left lung by video-assisted thoracic surgery, the histological findings once again confirmed a metastasis that originated from the pancreatic cancer. The patient refused chemotherapy and remained alive and relapse-free after the 10-month follow-up. Conclusion: Detection and resection of an isolated lung metastasis originating from pancreatic cancer may improve prognosis. Careful follow-up may be warranted to identify patients who might benefit from aggressive local treatment of oligometastasic pancreatic cancer.

Simple Pulmonary Eosinophilia Mimicking Lung Metastases on 18F-FDG PET/CT

“…Simple pulmonary eosinophilia may also cause an increase in FDG uptake 14 . In our case, the patient had a history of pancreatic cancer, and there were multiple pulmonary nodules with elevated FDG activity, which led to a misdiagnosis of lung metastases 15 . Finally, the pathology and the bronchoalveolar lavage fluid helped to confirm the diagnosis of simple pulmonary eosinophilia 3 .…”

“…14 In our case, the patient had a history of pancreatic cancer, and there were multiple pulmonary nodules with elevated FDG activity, which led to a misdiagnosis of lung metastases. 15 Finally, the pathology and the bronchoalveolar lavage fluid helped to confirm the diagnosis of simple pulmonary eosinophilia. 3 The current case indicates simple pulmonary eosinophilia should be included in the differential diagnosis of multiple pulmonary nodules with elevated FDG activity on PET/CT images.…”

Defining oligometastatic pancreatic cancer: a systematic review and critical synthesis of consensus

“…Novel multimodal preoperative therapy in pancreatic cancer have led to an increased number of case reports and retrospective series that in highly selected pancreatic cancer patients’ LCT of metastases might result in favorable outcomes as well. 44 , 105 , 106 , 107 , 108 , 109 , 110 , 111 , 112 , 113 , 114 In particular, complete response to chemotherapy based on imaging criteria has encouraged clinicians to seek resection of metastases in addition to the primary tumor as part of individualized treatment strategies. 44 , 115 , 116 …”