Single pancreatic and multiple hepatic metastases developing 6 years after left hemicolectomy for colon cancer: A...

A 50-year-old woman presented with a pancreatic tumor and multiple hepatic tumors identified via computed tomography (CT). The patient had undergone surgical resection for colon cancer 6 years earlier, followed by resection of a metastatic lung tumor 3 years ago. In the current presentation, primary pancreatic cancer with metastatic hepatic tumors was initially suspected. However, the possibility of previously resected colon cancer metastasizing to the pancreas also had to be considered. CT findings alone could not make this distinction. Therefore, endoscopic ultrasound-guided fine-needle aspiration was performed. Histopathological examination of the pancreatic tumor indicated adenocarcinoma, with features similar to those of the previously resected colon cancer. Immunohistochemical staining was negative for cytokeratin 7 but positive for cytokeratin 20, caudal-type homeobox 2, and special AT-rich sequence-binding protein 2. These findings indicated a pancreatic metastasis of colonic origin. In addition, a percutaneous ultrasound-guided biopsy of one of the hepatic tumors had histopathological findings that were similar to those of the pancreatic tumor. Hence, the patient was diagnosed with pancreatic and hepatic metastases from the previously resected colon cancer. Chemotherapy was initiated after this diagnosis.