Pancreatic resection for metastasis to the pancreas from colon and lung cancer, and osteosarcoma.
BACKGROUND
Pancreatic resection for a metastatic colon, lung cancer or an osteosarcoma has rarely been reported in the literature and there is controversy regarding recurrence and the overall survival of these patients. We herein evaluate the outcome of three patients who underwent pancreaticoduodenectomy for the aforementioned metastatic tumors to the pancreas.


METHODS
Clinical presentation included pyloric stenosis and acute gastrointestinal bleeding. One patient was asymptomatic and was diagnosed during follow-up for colon cancer. All the pancreatic lesions were located in the head of the pancreas, and the intervals between the diagnosis of the primary cancer and the pancreatic metastases were 6, 14 and 24 months. During exploration of the abdomen, additional metastatic lesions in the small intestine and liver were detected and resected in two patients. One patient died one month after surgery from massive gastrointestinal bleeding. The other two patients experienced relief from their symptoms but died from generalized carcinomatosis 16 and 27 months after pancreaticoduodenectomy.


CONCLUSIONS
Pancreatic resection for metastatic disease may be suggested for selected patients, even those with limited extrapancreatic disease. In this setting, it may offer good palliation and may prolong survival. In cases of acute duodenal bleeding resistant to conservative measures, pancreaticoduodenectomy may represent the only alternative for survival; however, significant morbidity and mortality should be expected.
Department of General Surgery, University Hospital of Heraklion, Heraklion, Crete, Greece.
Konstantinos
K
Lasithiotakis
Ioannis
I
Petrakis
George
G
Georgiadis
Stefanos
S
Paraskakis
George
G
Chalkiadakis
Emmanuel
E
Chrysos
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery; D000293:Adolescent; D001859:Bone Neoplasms / Q000473:pathology* / Q000601:surgery; D003110:Colonic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012516:Osteosarcoma / Q000473:pathology* / Q000601:surgery; D010180:Pancreatectomy / Q000379:methods; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary* / Q000601:surgery*; D011859:Radiography