title: Two cases of pancreatic ductal adenocarcinoma with intrapancreatic metastasis.
abstract: There are no standardized diagnostic criteria for intrapancreatic metastasis of pancreatic ductal adenocarcinoma (PDAC). Here, we report two cases of patients with PDAC who were pathologically diagnosed as harboring intrapancreatic metastasis. In both cases, the main lesions were located in the pancreatic body, and no other lesion was detected preoperatively. The patients were diagnosed with pancreatic body cancers and distal pancreatectomy was performed. Pathological findings revealed microscopic cancer nests, which had connections to neither the main lesion nor the premalignant lesion in the pancreatic tail parenchyma. In both cases, the histological type of the daughter lesion was quite similar to that of the main lesion. Hence, we diagnosed the daughter lesions as metastatic foci in the pancreas. Although intrapancreatic metastasis of PDAC has been regarded as a poor prognostic factor, few reports of intrapancreatic metastasis are available. This article reports two such cases and provides a review of the literature.
authors.affiliation: Yusuke Fujita, Minoru Kitago, Osamu Itano, Masahiro Shinoda, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo 160-8582, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Fujita
authors.affiliation: Yusuke Fujita, Minoru Kitago, Osamu Itano, Masahiro Shinoda, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo 160-8582, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Kitago
authors.affiliation: Yusuke Fujita, Minoru Kitago, Osamu Itano, Masahiro Shinoda, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo 160-8582, Japan.
authors.forename: Yohei
authors.initials: Y
authors.lastname: Masugi
authors.affiliation: Yusuke Fujita, Minoru Kitago, Osamu Itano, Masahiro Shinoda, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo 160-8582, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Itano
authors.affiliation: Yusuke Fujita, Minoru Kitago, Osamu Itano, Masahiro Shinoda, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo 160-8582, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Shinoda
authors.affiliation: Yusuke Fujita, Minoru Kitago, Osamu Itano, Masahiro Shinoda, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo 160-8582, Japan.
authors.forename: Yuta
authors.initials: Y
authors.lastname: Abe
authors.affiliation: Yusuke Fujita, Minoru Kitago, Osamu Itano, Masahiro Shinoda, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo 160-8582, Japan.
authors.forename: Taizo
authors.initials: T
authors.lastname: Hibi
authors.affiliation: Yusuke Fujita, Minoru Kitago, Osamu Itano, Masahiro Shinoda, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo 160-8582, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yagi
authors.affiliation: Yusuke Fujita, Minoru Kitago, Osamu Itano, Masahiro Shinoda, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo 160-8582, Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Fujii-Nishimura
authors.affiliation: Yusuke Fujita, Minoru Kitago, Osamu Itano, Masahiro Shinoda, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo 160-8582, Japan.
authors.forename: Michiie
authors.initials: M
authors.lastname: Sakamoto
authors.affiliation: Yusuke Fujita, Minoru Kitago, Osamu Itano, Masahiro Shinoda, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo 160-8582, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kitagawa
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D021441:Carcinoma, Pancreatic Ductal / Q000556:secondary* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D002760:Cholangiopancreatography, Endoscopic Retrograde; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008297:Male; D061206:Neoplasm Micrometastasis; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000473:pathology* / Q000601:surgery; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Carcinogenesis; Carcinoma; Neoplasm micrometastasis; Pancreatic ductal; Recurrence