Metastatic squamous cell carcinoma to the pancreas: Report of an extremely rare case

Abstract

Secondary pancreatic lesions are very uncommon. Resection of these metastatic lesions with a curative intent has been reported in selected patients; however, the survival benefit from these procedures has yet to be clearly determined. A 78-year-old male patient presented to our department with obstructive jaundice. Three years prior to presentation the patient had undergone right pneumonectomy, due to stage IIA, low-grade squamous cell lung carcinoma. After resection, the patient received adjuvant chemotherapy, with no evidence of local or systemic recurrence over the following 3 years. Abdominal computer tomography on admission revealed a 3-cm lesion located at the head of the pancreas, causing biliary obstruction. Endoscopic ultrasound biopsy revealed malignant cells, suspicious for squamous cell carcinoma. Due to the limited extent of the metastatic disease and in view of the patient's good condition, surgical resection was proposed and the patient successfully underwent pancreaticoduodenectomy. Histological examination of the resected specimen confirmed a squamous cell carcinoma, with an immunochemical profile similar to that of the primary lung tumor. Therefore, pancreatic resection with curative intent may be feasible in selected patients with secondary metastatic tumors. However, further studies are required in order to determine the benefit of these major procedures in terms of survival outcomes.

Pancreatic metastasis from squamous cell lung cancer: computed tomography and magnetic resonance imaging findings

“…To our knowledge, only eight cases of metastatic lung squamous cell carcinoma in the pancreas have been reported in the English literature worldwide to date. 4 , 9 – 15 We report the ninth and tenth cases of pancreatic metastasis secondary to squamous cell lung carcinoma ( Table 1 ). In the 10 cases, the patients’ age ranged from 44 to 78 years, and there was an obvious predilection for men, with a female to male ratio of 1:4.…”

A mass mimicking pancreatic adenocarcinoma, should hepatobiliary surgeons keep it in mind? a case report

“…The clinical presentation of patients with pancreatic metastasis from primary lung cancer varies widely with abdominal pain, weight loss and jaundice frequently reported. In many cases secondary lesions are discovered during the follow-up for their primary malignancy [ 3 ]. Clinicians should always keep in mind that pancreatic metastasis may be possible if there is a past medical history of surgically treated lung cancer.…”

“…Isolated metastasis to pancreas from lung cancer is an extremely rare entity, usually reported in case series and case reports in the medical literature; estimated to account for up to 3-5% of all pancreatic lesions [ 3 ]. The most common type of primary tumor that usually metastasizes to the pancreas is reported to be renal cell carcinoma, with the incidence of pancreatic metastases from pulmonary squamous cell carcinoma reaching ~1% of all secondary pancreatic lesions [ 3 , 4 ]. Many patients remain asymptomatic, whereas common symptoms that may encountered are jaundice and abdominal pain.…”

Malignant biliary obstruction due to metastatic non-hepato-pancreato-biliary cancer

“…Slightly over half are located in the head and 55% have metastases at the time of diagnosis. MBO caused by metastatic squamous cell lung carcinoma has also been reported, requiring investigation for a lung primary[ 262 ].…”