A Resectable Case of Pancreatic Metastasis from Ascending Colon Cancer

Gen Sugawara, Akihiro Yamaguchi, Masatoshi Isogai, Tohru Harada, Yuji Kaneoka, Masahiko Suzuki, Atsushi Akutagawa, Kiyoshi Suzumura and Tatsuya Usui

Department of Surgery, Ogaki Municipal Hospital

A 57-year-old woman previously undergoing right hemicolectomy for ascending colon canceer in January 1997, and right superior lobectomy for right pulmonary lobe metastasis in October 1999 was found in May 2000 to have elevated level of plasma CEA. Abdominal computed tomography (CT) and ultrasonography (US) showed a mass in the pancreas body and tail. Retrograde pancreatography showed main pancreatic duct obstruction. Under a diagnosis of pancreatic tumor, we resected the pancreas body and tail and spleen en block. The 8×5 cm tumor was shown histologically to be moderately differentiated tubular adenocarcinoma, identical to the colon cancer and the metastatic focus in the lung, with scattered stroma and a fibrous capsule formation on the border between lesions, leading to a diagnosis of pancreatic metastasis from ascending colon carcinoma. The postoperative course was good, and the patient was discharged 31 days after surgery. Cerebellar metastasis subsequently detected was resected. The patient remains metastasis free 4 years and 9 months after primary lesion resection. Only 11 cases of resection of pancreatic metastasis from colon cancer, including ours, have been reported in Japan. We present this case with a review of the literature.

Key words
colon cancer, pancreatic metastasis

Reprint requests
Gen Sugawara Department of Surgery, Ogaki Municipal Hospital
4-86 Minaminokawa-cho, Ogaki, 503-8502 JAPAN

Accepted
February 27, 2002

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