Abstract
A 69-year-old man had received high anterior resection for rectal cancer. Five years after the surgery, a liver metastasis was identified, and the metastasis was surgically resected. Three years after the liver surgery, a computed tomography (CT) examination demonstrated nodules in the lung and pancreas. The pulmonary nodule was resected and was diagnosed as a metastatic lung tumor from the rectal cancer. The pancreatic tumor was hypovascular and located in the pancreatic head, and showed a high fluorodeoxyglucose (FDG) accumulation on an FDG-positron emission tomography (PET)/CT examination. Because of a preoperative diagnosis of primary pancreatic cancer or metachronous pancreatic metastasis from rectal cancer, subtotal stomach-preserving pancreaticoduodenectomy was performed. There were no severe postoperative complications. Histopathological examination of the tumor revealed adenocarcinoma, consistent with that of the previous primary rectal cancer. Immunohistochemical staining for CK-7 and CK-20 revealed a similar pattern in the primary rectal cancer and the pancreatic tumor. These microscopic findings confirmed that the pancreatic tumor was a metachronous metastasis from the rectal cancer. The patient remains well without any recurrences 12 months after the pancreatic resection.
