Abstract
A 59-year-old man had undergone a low anterior resection and partial resection of the bladder for a rectal cancer (tub2, pSI (bladder), pN0, ly0, v0, pStageII) two years previously. Adjuvant chemotherapy with UFT had been done, however, an abdominal CT scan examination for the follow-up study revealed a tumor in the tail of the pancreas. The size of the tumor was 5 cm in diameter and there was no enhancement at the CT scan. The surrounding tissues were invaded by the tumor and the splenic vein was occluded, which is a typical pattern seen in cases of primary pancreatic cancers. Laboratory findings showed elevated levels of hemoglobin A1c (HbA1c) and carcinoembryonic antigen (CEA). With a diagnosis of cancer of the pancreatic tail (cT4 (PV(+)), cN1, cM0, cStageIVa), a distal pancreatectomy was performed. The histological diagnosis was a metastatic pancreatic tumor from the previous rectal cancer, because tumor cells were negative for CK7 and positive for CK20 and cdx-2 immunohistochemically. Chemotherapy was initiated and is still being given.
Only a small number of cases of metastatic pancreatic tumor have been reported and they were rarely resectable. Only 34 resectable cases have been reported in Japan.
