2006 Volume 39 Issue 6 Pages 729-735
A 56-year-old man hospitalized elsewhere for epigastralgia since May 2004 was diagnosed with descending colon cancer with solid tumors in the liver and pancreas. After undergoing left hemicolectomy, he was admitted to our hospital for further evaluation and treatment of the hepatic and pancreatic tumors. The absence of dilation of the main pancreatic duct led to a diagnosis of metastatic liver tumor that further metastasized to the local lymph node and invaded the pancreatic parenchyma, although the possibility of primary pancreatic head cancer with liver metastasis could not be denied due to elevated serum DUPAN-2. Because surgery could be curative if tumors had been of colorectal origin, the patient was eventually treated with pancreaticoduodenectomy and right hepatectomy in July 2005. Histopathologic studies showed that both hepatic and pancreatic tumors were compatible with metastasis from colon cancer having both well-and moderately differentiated components. Immunohistology showed that both colon and pancreatic tumors were positive for CEA/CK20 and negative for CK7, hence the final diagnosis of colon cancer with synchronous hepatic and pancreatic metastases. The patient died for liver and bone metastases 12 months after the surgical therapy.
