title: Metastasis of rectal adenocarcinoma to the pancreas. Two case reports and a review of the literature.
abstract: BACKGROUND
  The vast majority of pancreatic tumors are of pancreatic origin. Nonetheless, a variety of extrapancreatic tumors can involve the pancreas and may manifest with different clinicopathological characteristics.
  
  
  METHODS
  We report on two patients with a history of rectal cancer who were referred to our department with a pancreatic mass: one patient 2 years after a low anterior resection (TNM stage: pT3 pN0 pM0), the other patient 2.5 years after an abdominoperineal resection (TNM stage: pT3 pN1 pM0). In the first case, computed tomography showed a cystic mass in the pancreas but fine-needle biopsy followed by cytopathological analysis revealed only necrotic tissue. In the other patient, magnetic resonance tomography showed a hypodense structure in the pancreatic body/tail. Suspecting pancreatic tumors, distal pancreatectomies were carried out. Subsequent histological examination revealed metastases of rectal cancer in both cases.
  
  
  CONCLUSIONS
  In patients with a history of a malignant tumor, a newly diagnosed mass in the pancreas--although rare--should raise the suspicion of metastatic disease. Surgical resection may be an option for a curative approach which can be offered to otherwise healthy patients if there is no evidence of other metastases.
authors.affiliation: Department of General Surgery, University of Heidelberg, Germany.
authors.forename: Jeannine
authors.initials: J
authors.lastname: Bachmann
authors.forename: Christoph W
authors.initials: CW
authors.lastname: Michalski
authors.forename: Frank
authors.initials: F
authors.lastname: Bergmann
authors.forename: Markus W
authors.initials: MW
authors.lastname: Büchler
authors.forename: Jörg
authors.initials: J
authors.lastname: Kleeff
authors.forename: Helmut
authors.initials: H
authors.lastname: Friess
mesh_terms: D000230:Adenocarcinoma / Q000556:secondary* / Q000601:surgery; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000556:secondary* / Q000601:surgery; D012004:Rectal Neoplasms / Q000473:pathology*