CASE REPORT

JOP. J Pancreas (Online) 2007; 8(2):214-222.

Metastasis of Rectal Adenocarcinoma to the Pancreas. Two Case Reports and a Review of the Literature

Jeannine Bachmann1, Christoph W Michalski1, Frank Bergmann2, Markus W Büchler1, Jörg Kleeff1, Helmut Friess1

Departments of 1General Surgery and 2Pathology, University of Heidelberg. Heidelberg, Germany

ABSTRACT

Context The vast majority of pancreatic tumors are of pancreatic origin. Nonetheless, a variety of extrapancreatic tumors can involve the pancreas and may manifest with different clinicopathological characteristics.

Case report We report on two patients with a history of rectal cancer who were referred to our department with a pancreatic mass: one patient 2 years after a low anterior resection (TNM stage: pT3 pN0 pM0), the other patient 2.5 years after an abdominoperineal resection (TNM stage: pT3 pN1 pM0). In the first case, computed tomography showed a cystic mass in the pancreas but fine-needle biopsy followed by cytopathological analysis revealed only necrotic tissue. In the other patient, magnetic resonance tomography showed a hypodense structure in the pancreatic body/tail. Suspecting pancreatic tumors, distal pancreatectomies were carried out. Subsequent histological examination revealed metastases of rectal cancer in both cases.

Conclusion In patients with a history of a malignant tumor, a newly diagnosed mass in the pancreas - although rare - should raise the suspicion of metastatic disease. Surgical resection may be an option for a curative approach which can be offered to otherwise healthy patients if there is no evidence of other metastases.

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Keywords Colorectal Neoplasms; Neoplasm Metastasis; Pancreatic Neoplasms; Surgery

Correspondence Helmut Friess: helmut.friess@med.uni-heidelberg.de

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