Metachronous colonic metastasis from pancreatic cancer seven years post-pancreatoduodenectomy

Figure 1 Examinations at seven years after pancreatoduodenectomy. A: An abdominal computed tomography showing thickening of the ascending colon wall with enhancement and luminal narrowing (arrow); B: A contrast examination showing a 5-cm stricture of the ascending colon (arrow).

Figure 2 A pathological specimen showing a 5-cm wall thickening and a cobblestone-like appearance of the ascending colon.

Figure 3 Histological findings revealed the cancer nests invading from the subserosa to the muscular and submucosal layers of the colon. A: × 4; B: × 10.

Figure 4 Photomicrographs (× 10). A: Immunostaining showing cytokeratin 7 positivity in colonic metastasis; B: Immunostaining showing cytokeratin 20 negativity in colonic metastasis; C: Immunostaining showing cytokeratin 7 positivity in primary pancreatic cancer; D: Immunostaining showing cytokeratin 20 negativity in primary pancreatic cancer.