[A Case of Long-Term Survival after Resection of Postoperative Lung Metastasis from Pancreatic Cancer]

Pancreatic cancer has an extremely poor prognosis due to recurrence in the early postoperative period. We report here a case of long-term survival after radical pancreatic cancer resection for lung metastasis. A 63-year-old man was found to have a pancreatic head mass during abdominal ultrasound examination due to an elevated CA19-9 level. He was referred to our department with a diagnosis of pancreatic head cancer (cStage ⅡB), and pancreatoduodenectomy was performed. The pathology results showed a diagnosis of pancreatic head cancer (pStage ⅡB), and GEM (1,000 mg/m2) was administered for 6 months (6 courses) as postoperative adjuvant therapy. Two and a half years after surgery, a nodule appeared in the lower lobe of the right lung (S10) on CT. Although the nodule had been gradually increasing, it was unclear whether it was a primary lung cancer or a lung metastasis of pancreatic cancer. A wedge resection of the lower lobe of the right lung was performed 3 years and 3 months after the initial surgery to confirm the diagnosis. The pathology results were consistent with lung metastasis of pancreatic cancer, and the patient was diagnosed as a case of recurrent pancreatic cancer. TS-1 (100 mg/day) was administered for 6 months (4 courses) as postoperative adjuvant therapy. The patient is currently under outpatient follow-up with no recurrence, 6 years and 1 month after the initial surgery and 3 years and 11 months after the recurrence surgery.