title: Metachronous colonic metastasis from pancreatic cancer seven years post-pancreatoduodenectomy.
abstract: Colonic metastasis from other organs is very rare. Here we report the case of a 62-year-old man with a history of pancreatoduodenectomy for stage IIB pancreatic head cancer performed seven years back. He presented with abdominal distension and pain. Under the preoperative diagnosis of bowel obstruction, surgical treatment was performed, and a circumferential lesion causing bowel obstruction of the ascending colon was detected. A right hemicolectomy with lymph node dissection was performed. The specimen showed a 5-cm wall thickening with a cobble-stone like appearance of the ascending colon, which morphologically appeared scirrhous. Histological examination revealed cancer nests invading from the subserosa to the muscular and submucosal layers of the colon. Immunohistochemical analysis of the tumor cells demonstrated positive staining for cytokeratin 7, but negative for cytokeratin 20, which was the same as the previous pancreatic cancer specimen. These pathological and immunohistochemical features strongly supported the diagnosis of colonic metastasis from the pancreas. Thereafter, the patient received systemic chemotherapy, but unfortunately, he died 14 mo after the surgery.
authors.affiliation: Department of Surgery, Tokyo Metropolitan Bokutoh Hospital, Sumida-ku, Tokyo 1308575, Japan. kentaro.inada@hotmail.co.jp
authors.forename: Kentaro
authors.initials: K
authors.lastname: Inada
authors.forename: Dai
authors.initials: D
authors.lastname: Shida
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Noda
authors.forename: Satoru
authors.initials: S
authors.lastname: Inoue
authors.forename: Masahiro
authors.initials: M
authors.lastname: Warabi
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Umekita
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis; D001706:Biopsy; D017024:Chemotherapy, Adjuvant; D003082:Colectomy; D003110:Colonic Neoplasms / Q000737:chemistry / Q000556:secondary* / Q000601:surgery; D017809:Fatal Outcome; D006801:Humans; D007150:Immunohistochemistry; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D012086:Reoperation; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor
keywords: Colonic metastasis; Cytokeratin 20; Cytokeratin 7; Immunohistochemical staining; Pancreatic cancer
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