[Pancreatic metastasis from lung cancer: report of an autopsy case]

A 69 year-old man with abnormal lung shadows in the right lung field was admitted to our hospital. A chest computed tomography (CT) scan showed a lung tumor with hilar and mediastinal lymph node swelling. A CT scan of the abdomen demonstrated a solitary pancreatic head tumor with a diameter of 3 cm. Pathological examination of a transbronchial biopsy specimen revealed squamous cell carcinoma (SCC) of the lung. Since obstructive jaundice had progressed rapidly, the patient received endoscopic nasobiliary drainage (ENBD) and stent-drainage therapy prior to chemotherapy using gemcitabine. However, he died 4 months later of respiratory failure and systemic candidiasis associated with progression of the cancer. An autopsy was performed, and microscopic and immunohistochemical examination revealed that the pancreatic tumor was a metastasis from lung cancer. To our knowledge, obstructive jaundice due to pancreatic metastasis from lung SCC, especially that preceding the advent of a clinical manifestation of primary lung cancer, has rarely been reported.