Abstract

BackgroundMetastatic pancreatic tumors from lung cancer (MPTLC) constitute 3% of all metastatic pancreatic tumors. We present an extremely rare case of cystic MPTLC that was difficult to distinguish from intraductal papillary mucinous neoplasm (IPMN).Case presentationThe patient was a 74-year-old woman who underwent lobectomy of lung cancer 2 years before presentation to our hospital. She was referred to our department for resection of cystic pancreatic tumors, which were diagnosed as IPMN with high-risk stigmata. Abdominal computed tomography (CT) showed a 37-mm-wide cystic tumor with a contrasted solid nodule in the pancreatic head and a 17-mm-wide cystic tumor in the pancreatic tail. We performed a total pancreatectomy for these lesions. According to histopathological and immunohistochemical findings, the tumors were diagnosed as metastatic pancreatic tumors from lung cancer.ConclusionIn this case, the cystic morphology was formed by eosinophilic secretions from tumor cells, and it was difficult to distinguish from IPMN with high-risk stigmata. We consider this case, based on the variable clinical findings, an extremely rare variant of MPTLC.

Highlights

  • In this case, the cystic morphology was formed by eosinophilic secretions from tumor cells, and it was difficult to distinguish from intraductal papillary mucinous neoplasm (IPMN) with high-risk stigmata

  • Metastatic pancreatic tumors from lung cancer (MPTLC) is mainly treated with chemotherapy, pancreatectomy is sometimes performed in cases of solitary or metachronal metastasis

  • We had confirmed that the cystic tumor and main pancreatic duct were close, we could not define the link between the main pancreatic duct and the cyst (Fig. 2). 18F-fluorodeoxyglucose positron-emission tomography (FDG-PET) showed FDG uptake (SUV max 1.9) at the lesion in the pancreatic head

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Summary

Conclusion

The cystic morphology was formed by eosinophilic secretions from tumor cells, and it was difficult to distinguish from IPMN with high-risk stigmata.

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