[A case of simultaneous resection of pancreatic tail and transverse hematogenous metastasis]

A 51-year-old male patient visited our hospital after a positive result for a stool test for occult blood. Subsequent lower gastrointestinal endoscopy showed a neoplastic lesion in the transverse colon, and abdominal computed tomography revealed a tumor in the tail of the pancreas. Since there was the possibility of multiple cancers with pancreatic cancer and transverse colon cancer, resection of pancreatic tail and transverse colectomy were performed. Histopathological findings: The pancreatic lesion was found to be a moderately differentiated tubular adenocarcinoma, and the lesion in the transverse colon was mainly located in the submucosal layer. In light of the principal lesion having the same histopathological characteristics as the pancreatic lesion, it was diagnosed as hematogenous metastasis of pancreatic cancer to transverse colon. Postoperative course: After 9 courses of 3-week administration of gemcitabine(GEM) and 1-week cessation, he developed hepatic metastasis. The treatment with GEM+S-1 was additionally repeated 7 times, but the patient was not responsive to the treatment, and died 1 year and 6 months after his first visit to our hospital.

Surgery is not generally indicated in patients with pancreatic cancer with hematogenous metastasis. In this case, a comparatively long-term survival period was achieved after simultaneous resections.