A Case of Rectal Cancer Metastasized to the Pancreas and Liver 11 Years from after the Primary Surgery

Naoki Tani, Akinori Noguchi, Hiroki Takeshita, Yusuke Yamamoto, Tadao Itoh, Masayoshi Nakanishi, Yasushi Suganuma, Masahide Yamaguchi, Shinji Okano and Tetsuro Yamane

Department of Surgery, Matsushita Memorial Hospital

A 78-year-old man who had undergone radical surgery for rectal cancer with liver metastasis 11 years earlier exhibited an elevated serum carcinoembryonic antigen level in November 2004. An abdominal CT examination demonstrated a mass in the pancreatic body and S4 of the liver. The main pancreatic duct was shown as sudden obstruction in ERCP, the pancreatic cancer with liver metastasis was suspected. A distal pancreatectomy and splenectomy, along with a partial resection of the liver, was performed. The pathologic diagnosis was moderately differentiated adenocarcinoma, compatible with metastases from the rectal carcinoma. Cases of pancreatic metastasis from colorectal cancer are rare, though several cases have shown that multi organ metastasis during the course of disease usually indicates a poor prognosis. Whether this disease is curable should be carefully determined, particularly when surgical treatment is considered. According to the literature, the prognosis of the resected pancreatic metastasis after the long period from primary operation may be relatively good.

Key words
colorectal cancer, pancreatic metastasis, liver metastasis

Reprint requests
Naoki Tani Department of Surgery, Matsushita Memorial Hospital
5-55 Sotojima-cho, Moriguchi, 570-8540 JAPAN

Accepted
March 28, 2007

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