Abstract
The pancreas is uncommon site for metastasis from cancer of the papilla of Vater. We herein present a rare surgical case of a metachronous metastasis developing in the remnant pancreas after a pancreatoduodenectomy for cancer of the papilla of Vater. A 55-year-old woman had undergone pylorus-preserving pancreaticoduodenectomy for cancer of the papilla of Vater (TNM: Stage II). During the follow-up period, CA 19-9 increased to 141.2 U/mL (normal range: 0-37) 19months after the resection. Abdominal and chest CT disclosed a solid mass measuring 10 mm in size in the tail of the remnant pancreas without any other distant metastasis. These findings were considered to represent an isolated pancreatic metastasis from cancer of the papilla of Vater. The patient underwent distal pancreatectomy with splenectomy. Histologically, the tumor consisted of a well-differentiated tubular adenocarcinoma, the same diagnosis as that of the first tumor with no involvement of pancreatic ducts. Based on these histological findings, the pancreatic tumor was diagnosed as a metastasis from cancer of the papilla of Vater. To our knowledge, this case is the first report of a resection for pancreatic metastasis from cancer of the papilla of Vater after a pancreaticoduodenectomy.
