title: A case of isolated pancreatic metastasis of gastric cancer presenting problematic discrimination from gastropancreatic double cancer.
abstract: We experienced a case of isolated pancreatic metastasis caused by gastric cancer which showed high levels of the tumor markers relevant to pancreatic cancer. The patient was a 59-year-old man who had tumors in both the gastric antrum and pancreatic head. He was diagnosed as having double cancer of the stomach and pancreas on account of the high values of pancreatic cancer-associated markers, and underwent operation. This resulted in non-curable resection attributable to broad lymph node metastasis. The resected specimen lacked continuity between the pancreas tumor and gastric tumor, and the pancreatic tumor was histologically diagnosed as metastasis from the gastric cancer. Moreover, the advanced lymph vessel invasion suggested possible metastasis through the lymph ducts. The present case is a rare metastatic form because there has been no report of lymphogenous isolated pancreatic metastasis of gastric cancer. In advanced gastric cancer, the possibility of pancreatic metastasis should be always borne in mind, and pancreatic biopsy may be taken into account at times. Radical operation may be performed corresponding to the degree of each stage of the double cancer of stomach and pancreas. However, considering the low possibility of curable resection for pancreatic metastasis of gastric cancer, other treatments than surgery should also be considered.
authors.affiliation: First Department of Surgery, National Sengokusou Hospital, Osaka, Japan. tnakai@jtw.zaq.ne.jp
authors.forename: Takehiro
authors.initials: T
authors.lastname: Nakai
authors.forename: Tomoo
authors.initials: T
authors.lastname: Shimomura
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nakai
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D014408:Biomarkers, Tumor / Q000097:blood; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003106:Colon / Q000473:pathology / Q000601:surgery; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D016577:Pancreaticoduodenectomy; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
chemical_list: D014408:Biomarkers, Tumor