A case of surgically-treated pancreatic metastasis from gastric cancer

Abstract

A 50-year-old woman underwent distal gastrectomy for gastric cancer in June 2003 (stageII). UFT adjuvant chemotherapy was continued for five months. Thereafter, she developed otitis media and liver dysfunction. UFT administration was stopped and 5FU tablet administration was started two months later. Two months thereafter in May 2004, echo showed a 13mm in diameter tumor on the surface of the pancreatic head. 5FU tablet administration was continued. The tumor became undetectable on echo. 5FU tablet administration was stopped in June 2005. The pancreatic tumor was detected again on echo in February 2006. PET showed abnormal uptake only in the pancreatic mass. We removed the tumor locally. The histopathologic diagnosis of the pancreatic tumor was the same type as the previous gastric cancer. About 70% of the tumor was surrounded by pancreatic tissue and no lymph node structure was seen in the tumor. The tumor was compatible with pancreatic metastasis from gastric cancer. Post-operative S-1 adjuvant chemotherapy was performed for four years after the second operation, and the patient has survived without recurrence. Pancreatic metastasis of gastric cancer manifests no operative indications in many cases. However, we should evaluate the indications for surgical treatment when no other organic metastases are recognized.