A Case of Solitary Pancreatic Metastasis from Gallbladder Cancer

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  • Kosuge Shinya
    Department of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University
  • Noji Takehiro
    Department of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University
  • Go Masaru
    Department of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University Department of Surgical Pathology, Hokkaido University Hospital
  • Tanaka Kimitaka
    Department of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University
  • Matsui Aya
    Department of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University
  • Nakanishi Yoshitsugu
    Department of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University
  • Asano Toshimichi
    Department of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University
  • Nakamura Toru
    Department of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University
  • Tsuchikawa Takahiro
    Department of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University
  • Mitsuhashi Tomoko
    Department of Surgical Pathology, Hokkaido University Hospital
  • Hirano Satoshi
    Department of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University

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  • 胆囊癌孤立性膵転移の1例

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Abstract

<p>A 54-year-old man underwent radical cholecystectomy, extrahepatic bile duct resection, lymph node dissection, and choledochojejunostomy for gallbladder cancer associated with pancreaticobiliary maljunction. The histopathological diagnosis was moderately differentiated adenocarcinoma; pT2, pN0, and pStage II. Two years and 10 months after surgery, abdominal US revealed a hypoechoic mass of 11 mm with an irregular shape and a prolonged contrast effect in the pancreatic body. Histological examination using endoscopic ultrasound fine-needle aspiration revealed that the tumor was adenocarcinoma. Distal pancreatectomy was performed under a diagnosis of pancreatic cancer cT3N0M0 cStage IIA. Histopathological examination revealed two lesions in the pancreatic body, both of which were poorly to moderately differentiated adenocarcinoma. Since the morphology of the lesions on HE staining and immunohistochemistry were consistent with the gallbladder cancer, the final diagnosis was pancreatic metastasis from gallbladder cancer. At 18 months after surgery, the patient is alive without recurrence. Most metastatic pancreatic tumors are metastases from renal cell carcinoma, sarcoma, colorectal cancer, or malignant melanoma, whereas pancreatic metastasis from gallbladder cancer is extremely rare. Thus, we report this case as an example of solitary pancreatic metastasis from gallbladder cancer.</p>

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