[A case of resectable lung metastasis one year six months after surgery for pancreatic cancer].
The patient was a 68-year-old man who underwent pylorus-preserving pancreaticoduodenectomy for cancer of the pancreatic head in March 2012. Pre-operative chest computed tomography (CT) revealed a scar-like shade approximately 1.5 cm in length in the right middle lobe of the lung, but an active metastasis was not suspected. Adjuvant S-1 was initiated in June the same year at 100 mg/day and reduced to 50 mg/day in October because of neutropenia. The internal structure of the right middle lobe was observed to be uneven on a CT scan obtained in July 2013, and the shading increased to approximately 3 cm in length along with spicula. Brushing and transbronchial lung biopsy(TBLB)were performed. No other distant organ metastases were detected on a whole body search. Diagnosis was between a solitary lung metastasis of pancreatic cancer or cT2N0M0, StageIB primary lung cancer. The right middle lobe of the lung was resected via thoracoscopy along with lymph node dissection in September 2013. Histological examination revealed that the lesion was a well differentiated adenocarcinoma, with negative immunostaining for thyroid transcription factor-1(TTF-1) and Napsin A, and positive staining for cytokeratin (CK)7 and CK20, consistent with a solitary lung metastasis of pancreatic cancer. This report documents a rare case of pancreatic cancer with a solitary, resectable lung metastasis without involvement of other organs.
Dept. of Surgery, Tokyo Metropolitan Ohtsuka Hospital.
Takuya
T
Nakada
Haruya
H
Koshiishi
Ken
K
Imaizumi
Tomohiro
T
Murata
Michiyo
M
Tokura
Mayumi
M
Hoshino
Hiroshi
H
Goto
Tetsunori
T
Yoshimura
Eisuke
E
Takahashi
Mizuhito
M
Otsuji
D000230:Adenocarcinoma / Q000556:secondary / Q000601:surgery*; D000368:Aged; D006801:Humans; D008175:Lung Neoplasms / Q000556:secondary / Q000601:surgery*; D008197:Lymph Node Excision; D008297:Male; D010190:Pancreatic Neoplasms / Q000473:pathology* / Q000601:surgery; D016577:Pancreaticoduodenectomy; D014057:Tomography, X-Ray Computed