Metastatic Pulmonary Adenocarcinoma 13 Years After Curative Resection for Pancreatic Cancer: Report of a Case and Review of Japanese Literature
Abstract
Context For the majority of patients, ductal adenocarcinoma of the pancreas remains a lethal disease. Currently, surgical extirpation for localized disease offers the only chance for long-term survival. Case report We report a patient who underwent successful resection of isolated lung metastasis occurring 13 years after pancreatic cancer resection. A 59-year-old woman underwent distal pancreatectomy for pancreatic cancer 13 years previously, followed by adjuvant chemotherapy, and was followed-up at the outpatient clinic of a local hospital. From around June 2010, she noticed bloody sputum, so she visited a local hospital. Since her chest X-ray and CT revealed a 1.5 cm mass shadow in the segment 10 of her right lung and she was referred to the Respiratory Disease Center of our hospital. As a result of through examinations, she was strongly suspected of having lung metastasis of pancreatic cancer, and underwent partial pneumonectomy. Postoperative histopathological examination of the resected specimen was consistent with lung metastasis of pancreatic cancer. She is still alive and currently receives third line of chemotherapy. Conclusion Patients who have achieved long-term survival after pancreatic cancer resection and can tolerate surgery may benefit from resection of a lung metastasis of pancreatic cancer in terms of survival, if it controls the metastasis.
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References
Mayo S C, Nathan H, Cameron J L, Olino K, Edil B H, Herman J M, et al. Conditional survival in patients with pancreatic ductal adenocarcinoma resected with curative intent. Cancer 2011; 20: doi: 10.1002/cncr.26553. [PMID: 21935914].
Conlon K C, Klimstra D S, Brennan M F. Long-term survival after curative resection for pancreatic ductal adenocarcinoma. Clinicopathologic analysis of 5-year survivors. Annals of Surgery 1996; 223: 273-9. [PMID:8604907].
Barthes F L P, E, Fabre-Guillevin C F, Cazes A, Dujon A, Riquet M. Lung metastasis surgery, yesterday and now. Revue des maladies respiratoires 2011; 28: 1146-54. [PMID:22123141].
Thomford NR,Woolner LB,Clagett OT. The surgical treatment of metastatic tumors in the lung. The Journal of Thoracic and Cardiovascular Surgery 1965; 49: 357-63. [PMID:14265951].
Ito H, Kimura F, Shimizu H, Togawa A, Miyazaki M, Fujisawa T. A radically resected case of lung metastases from advanced pancreatic cancer, occurred nine years following a total pancreatectomy. Nihon Rinsyo Geka Gakkaizasshi (Journal of Japan Surgical Association) 2003; 64: 1366-69.
Arnaoutakis G J, Rangachari D, Laheru D A, Iacobuzio-Donahue C A, Hruban R H, Herman J M, et al. Pulmonary resection for isolated pancreatic adenocarcinoma metastasis: an analysis of outcomes and survival. J Gastrointest Surg 2011; 15: 1611-7. [PMID:21725701].
Barugola G, Falconi M, Bettini R, Boninsegna L, Casarotto A, Salvia R, Bassi C, Pederzoli P. The determinant factors of recurrence following resection for ductal pancreatic cancer. JOP. J Pancreas (Online) 2007; 8: 132-140.
Emoto S, Kamachi H, Tahara M, Kamiyama T, Matsushita M, Todo S. A case of lung metastasis occurring 6 years after pancreaticoduodenectomy for pancreas cancer. Nihon Rinsyo Geka Gakkaizasshi(Journal of Japan Surgical Association) 2010; 71: 1034-38.
Sperti C, Pasquali C, Piccoli A, Pedrazzoli S. Recurrence after resection for ductal adenocarcinoma of the pancreas. World Journal of Surgery 1997; 21: 195-200. [PMID:8995078].
Aiura K, Takahashi S, Ueda M, Kojima M, Handa Kan, Hibi T, et al. Analysis of autopsy findings in long-term survivors after surgical resection for invasive ductal carcinoma of the pancreas. Suizo (Journal of Japan Pancreas Society) 2007; 22: 130-6.
Takano K, Kurosaki I, Minagawa M, Kitami C, Date K, Hatakeyama K. Clinicopathological features of delayed isolated lung metastases after radical pancreatectomy for pancreatic cancer. Nihon Syokakigeka Gakkaizasshi (Jpn J Gastroenterol Surg) 2010; 43: 1270-75.
Yasuda K, Kataoka M, Niguma T, Mimura T, Ohara T. Resection of lung metastases from pancreatic cancer -Report of two cases-. Nihon Rinsyo Geka Gakkaizasshi (Journal of Japan Surgical Association) 2009; 70: 691-9.
Shimada J, Itoh K, Nishimura M, Yanada M, Terauchi K, Shimomura M, et al. Successful resection for solitary lung metastasis from pancreatic carcinoma: A case report. Nihon Kokyukigeka Gakkaizasshi (Jpn Assoc Chest Surg) 2005; 19: 581-84.
Enomoto Y, Saitoh Y, Tanimura S, Maeda S, Katayama H, Koizumi K. Intraoperative cytodiagnosis useful in a resectable case of solitary lung metastasis of pancreatic cancer (in Japanese with English abstract). Nihon Kokyukigeka Gakkaizasshi (Jpn Assoc Chest Surg) 2009; 23: 75-80.
Nakamura N, Miyagi E, Murata S, Kawaoi A, Katoh R. Expression of tyroid transcription factor-1 in normal and neoplastic lung tissues. Modern Pathology 2002; 15: 1058-67. [PMID:12379752].
Copyright (c) 2014 Yuhei Kitasato, Masamichi Nakayama, Gen Akasu, Munehiro Yoshitomi, Kazuhiro Mikagi, Yuichiro Maruyama, Ryuichi Kawahara, Hiroto Ishikawa, Toru Hisaka, Masafumi Yasunaga, Hiroyuki Horiuchi, Naoyuki Saito, Shinzo Takamori, Yoshinobu Okabe, Masayoshi Kage, Hisafumi Kinoshita, Hiroyuki Tanaka
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