Abstract
BackgroundPancreatic ductal adenocarcinoma (PDAC) readily metastasizes to the lymph nodes, liver, lung, and peritoneum; however, gastric and gallbladder metastases are rare. We report a case of metachronous gastric and gallbladder metastases from PDAC.Case presentationThe patient is a 71-year-old man who underwent distal pancreatectomy for PDAC. Seventeen months after the surgery, a 30-mm nodule was detected at the lesser curvature of the stomach, which was diagnosed as recurrence of PDAC in the lymph nodes. He then received gemcitabine and S-1 combination chemotherapy for 6 months. Because tumor size remained approximately the same and tumor marker levels decreased, total gastrectomy and cholecystectomy were performed. Pathological examination showed well-differentiated tubular adenocarcinoma in the subserosa and muscularis propria of the stomach and gallbladder. The patient remains alive at 41 months after the second surgery with liver metastasis.ConclusionWe reported a rare case of metachronous gastric and gallbladder metastases from pancreatic body cancer.
Highlights
Pancreatic ductal adenocarcinoma (PDAC) readily metastasizes to the lymph nodes, liver, lung, and peritoneum; gastric and gallbladder metastases are rare
We reported a rare case of metachronous gastric and gallbladder metastases from pancreatic body cancer
We describe a case of metachronous gastric and gallbladder metastases from pancreatic body cancer
Summary
Prognosis in patients with pancreatic ductal adenocarcinoma (PDAC) remains dismal, with a 5-year survival rate below 10% [1, 2]. Case presentation A 71-year-old man with a history of atrial fibrillation, acute appendicitis, and early esophageal cancer treated with endoscopic submucosal dissection underwent distal pancreatectomy with splenectomy for treatment of. Based on these findings, we diagnosed lymph node metastasis of PDAC invading the gastric wall, and the patient was treated with gemcitabine and S-1 combination (GS) therapy for 6 months. There was a tumor in the neck of gallbladder; pathological examination revealed this was a welldifferentiated tubular adenocarcinoma in the subserosa (Fig. 3c, d). As the pathological findings of these tumors were similar to the lesion initially resected by distal pancreatectomy, we diagnosed metachronous gastric and gallbladder metastases from PDAC. At 41 months after the second surgery, the patient remained alive
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