Pancreatic metastasis from colon adenocarcinoma: a case report

Pancreatic metastasis from colon adenocarcinoma is an exceedingly rare clinical entity. Here, we report a 65-year-old female who presented with a 1-month history of epigastric pain, abdominal distension, nausea, and vomiting. An initial abdominal computed tomography (CT) scan revealed a hypodense pancreatic mass accompanied by incomplete intestinal obstruction. Given the diagnostic uncertainty, endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of the pancreatic lesion and colonoscopic biopsy of the colon were performed. Histopathological and immunohistochemical analyses confirmed the pancreatic tumor as a metastatic tumor originating from primary colon adenocarcinoma. The patient was eventually transferred to the oncology department for further antitumor treatment. EUS-FNA, when paired with immunohistochemical profiling, is an indispensable tool for differentiating pancreatic metastases from primary pancreatic adenocarcinoma, thereby guiding appropriate oncologic management and reducing the risk of misdiagnosis.