title: Margin-negative limited resection of metastatic pancreatic tumors from rectal cancer preoperatively diagnosed by endoscopic ultrasound-guided fine-needle aspiration biopsies: report of two cases.
abstract: Pancreatic tumor metastasis from colorectal cancer is very rare. This study evaluated the significance of an endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNAB) and surgical treatment. Case 1 was a 67-year-old male with a history of rectal cancer (6 years ago) and lung metastases (5 years ago) who had two masses in the pancreatic head and body. Case 2 was a 58-year-old male with the history of rectal cancer and simultaneous lung metastasis (7 years ago) who had a mass in the pancreatic body. Imaging studies showed stenosis of the pancreatic duct with distal dilatation in both cases, mimicking primary pancreatic cancer. An EUS-FNAB with immunohistochemical staining made a definitive diagnosis of pancreatic metastasis from rectal cancer. Both patients received margin-negative limited resection, middle-segment-preserving pancreatectomy and distal pancreatectomy, respectively, and were alive 16 and 6 months after pancreatectomy, respectively. An EUS-FNAB is helpful to make a definitive diagnosis of pancreatic metastasis and in determining the subsequent therapeutic approach.
authors.affiliation: Department of Hepatobiliary Pancreatic and Transplant Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-0001, Japan, taneamail0827@gmail.com.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Tanemura
authors.forename: Shugo
authors.initials: S
authors.lastname: Mizuno
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Okura
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Inoue
authors.forename: Haruyuki
authors.initials: H
authors.lastname: Takaki
authors.forename: Keisuke
authors.initials: K
authors.lastname: Nishimura
authors.forename: Katsunori
authors.initials: K
authors.lastname: Uchida
authors.forename: Shuji
authors.initials: S
authors.lastname: Isaji
mesh_terms: D000368:Aged; D044963:Biopsy, Fine-Needle / Q000379:methods*; D015179:Colorectal Neoplasms / Q000473:pathology*; D019160:Endosonography / Q000379:methods*; D006801:Humans; D008175:Lung Neoplasms / Q000556:secondary; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D057234:Preoperative Period; D016896:Treatment Outcome