Abstract
We report a case of pancreatic metastasis from gastric cancer. A 75-year-old man underwent total gastrectomy for gastric cancer followed by adjuvant chemotherapy with S-1 for 12 months. After 4 years of gastrectomy, contrast enhanced CT demonstrated a splenic vein thrombus (1.5 cm). The thrombus extended to the portal vein over a period of 7 months. FDG-PET revealed increased uptake at the pancreas body, but no findings could be seen at the pancreas body on CT. MRCP showed stricture of main pancreatic duct. Although it was difficult to confirm the diagnosis, primary pancreatic cancer or pancreatic metastasis from gastric cancer were suspected. Distal pancreatectomy with tumor thrombectomy was performed. Macroscopic findings showed a 3.5 cm solid tumor at the pancreatic body with the tumor thrombus. Microscopic examination revealed moderately differentiated adenocarcinoma compatible with pancreatic metastasis from gastric cancer. The patient received adjuvant chemotherapy with S-1 after surgery and revealed no signs of recurrence. This is a rare case of pancreatic metastasis from gastric cancer accompanied by tumor thrombus.
