A Resected Case of Metastatic Carcinoma of the Pancreas Head after Resection for the Rectal Carcinoma

Norihiro Yuasa, Yuji Nimura, Naokazu Hayakawa, Junichi Kamiya, Shoji Maeda, Katsushi Okamoto, Shigehiko Shionoya

First Department of Surgery, Nagoya University School of Medicine

A case of metastasis of rectal carcinoma to the pancreas is reported. The patient was a 57-year-old man. Metastatic tumors were revealed in the pancreas and the pelvic cavity by computed tomography 18 months after radical surgery for rectal carcinoma. However no metastases were found in the lung, liver, or bones. Endoscopic retrograde cholangiopancreatography revealed an obstruction of the main pancreatic duct at the head of the pancreas, and the condition was histologically diagnosed as pancreatic metastasis by duodenoscopic biopsy of the pancreatic duct. The patient underwent pancreatoduodenectomy with partial resection of the superior mesenteric vein. The surgical specimen revealed regional lymph-node metastases, a tumor thrombus in the superior mesenteric vein and intraductal growth of the tumor in the pancreatic duct. Unfortunately, the tumor in the pelvic cavity could not be resected bacause of severe intraabdominal adhesion. Therefore radiation therapy and intraarterial infusion chemotherapy were carried out. Nevertheless, this experience suggested the validity of aggressive surgery for locarized metastasis of the pancreas.

Key words
pancreatic tumor, pancreatic metastasis, recurrence of rectal cancer

Reprint requests
Norihiro Yuasa First Department of Surgery, Nagoya University School of Medicine
65 Tsurumai-cho, Showa-ku, Nagoya, 466 JAPAN

Accepted
January 10, 1990

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