A case report of resection for postoperative lung metastasis of pancreatic cancer after systemic chemotherapy

Abstract

We often encounter recurrence after surgery for pancreatic cancer. Systemic chemotherapy is usually undergone for such recurrence, however, prognosis is very poor. We reported a case whose postoperative lung metastasis of pancreatic cancer was able to resect after systemic chemotherapy. The patient was a 56-year-old female who underwent distal pancreatectomy for invasive ductal carcinoma of the pancreatic body in 2012. Pathological examination of the resected specimen demonstrated that moderately differentiated tubular adenocarcinoma invaded into splenic vein and diagnosed as Stage IIA (pT3 pN0 M0) according to the seventh edition of TNM classification. Postoperative course was uneventful and she received standard adjuvant chemotherapy with gemcitabine for six months. One year after operation, bilateral and multiple lung metastases were shown on computed tomography. Consequently, we started systemic chemotherapy with S-1 and continued for 2 years and 6 months. No other distant metastases than lung presented and the number of lung metastases decreased by chemotherapy. Finally, only one nodule remained in right lung on computed tomography, therefore, we considered to be resectable. She underwent surgery for lung metastasis after four years of the operation for primary pancreatic cancer, and pathological examination confirmed lung metastasis of pancreatic cancer. Now, one year has passed since lung metastasis was resected, there was no evidence of recurrence. In conclusion, we reported a case that postoperative lung metastasis of pancreatic cancer became resectable by systemic chemotherapy and successfully treated by surgery.