Case Report
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World J Gastroenterol. Mar 14, 2013; 19(10): 1665-1668
Published online Mar 14, 2013. doi: 10.3748/wjg.v19.i10.1665
Metachronous colonic metastasis from pancreatic cancer seven years post-pancreatoduodenectomy
Kentaro Inada, Dai Shida, Kazumasa Noda, Satoru Inoue, Masahiro Warabi, Nobutaka Umekita
Kentaro Inada, Dai Shida, Kazumasa Noda, Satoru Inoue, Nobutaka Umekita, Department of Surgery, Tokyo Metropolitan Bokutoh Hospital, Sumida-ku, Tokyo 1308575, Japan
Masahiro Warabi, Department of Pathology, Tokyo Metropolitan Bokutoh Hospital, Sumida-ku, Tokyo 1308575, Japan
Author contributions: Inada K, Shida D, Noda K, Warabi M, Inoue S and Umekita N collected the data and administered the treatment; Inada K prepared the manuscript; Shida D was responsible for writing the paper and its supervision.
Correspondence to: Dr. Kentaro Inada, Department of Surgery, Tokyo Metropolitan Bokutoh Hospital, 4-23-15 Kotobashi, Sumida-ku, Tokyo 130-8575, Japan. kentaro.inada@hotmail.co.jp
Telephone: +81-3-36336151 Fax: +81-3-36336173
Received: November 13, 2012
Revised: January 3, 2013
Accepted: January 29, 2013
Published online: March 14, 2013
Processing time: 121 Days and 4 Hours
Abstract

Colonic metastasis from other organs is very rare. Here we report the case of a 62-year-old man with a history of pancreatoduodenectomy for stage IIB pancreatic head cancer performed seven years back. He presented with abdominal distension and pain. Under the preoperative diagnosis of bowel obstruction, surgical treatment was performed, and a circumferential lesion causing bowel obstruction of the ascending colon was detected. A right hemicolectomy with lymph node dissection was performed. The specimen showed a 5-cm wall thickening with a cobble-stone like appearance of the ascending colon, which morphologically appeared scirrhous. Histological examination revealed cancer nests invading from the subserosa to the muscular and submucosal layers of the colon. Immunohistochemical analysis of the tumor cells demonstrated positive staining for cytokeratin 7, but negative for cytokeratin 20, which was the same as the previous pancreatic cancer specimen. These pathological and immunohistochemical features strongly supported the diagnosis of colonic metastasis from the pancreas. Thereafter, the patient received systemic chemotherapy, but unfortunately, he died 14 mo after the surgery.

Keywords: Colonic metastasis; Pancreatic cancer; Immunohistochemical staining; Cytokeratin 7; Cytokeratin 20