A Rare Case of Metastasis to the Pancreas From a Primary Transitional-Cell Urinary Bladder Carcinoma

Pancreatic cancer (PC) occurs when changes (mutations) in the pancreas cells lead them to multiply out of control. A mass of tissue can result. Sometimes, this mass is benign (not cancerous). In PC, however, the mass is malignant (cancerous). A 79-year-old male presents to the emergency department with complaints of yellow discoloration of the eyes and body as well as itching all over the body. On general examination, his vitals were normal. Laboratory investigations showed raised levels of bilirubin and hepatic enzymes. The CT abdomen study revealed abnormal enhancing soft tissue density in the pancreatic head region obstructing the pancreatic duct and common bile duct leading to its proximal gross with upstream dilatation. The lesion described lesion in the pancreatic head region is of a malignant neoplastic etiology and needed to be evaluated with endoscopic retrograde cholangiopancreatography (ERCP), biopsy, and histopathology correlation. Associated pancreatic parenchymal atrophy was also seen along with gross dilatation of the extrahepatic and intrahepatic biliary system. There were no associated enlarged draining lymph nodes and minimal free fluid was seen in the peritoneal cavity. Following the deployment of a stent in the common bile duct, the patient was discharged. The patient prognosis was good and the patient was scheduled for routine blood work after four weeks to assess bilirubin levels and hepatic enzymes.