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. 2019 Feb 13;5(1):21.
doi: 10.1186/s40792-019-0581-1.

A case of successfully resected metachronous gastric and gallbladder metastases from pancreatic body cancer

Makoto Takahashi  1 , Hideyuki Yoshitomi  2 , Atsushi Kato  3 , Katsunori Furukawa  1 , Tsukasa Takayashiki  1 , Satoshi Kuboki  1 , Shigetsugu Takano  1 , Kensuke Sugiura  1 , Keishi Kawasaki  1 , Masaru Miyazaki  1   3 , Masayuki Ohtsuka  1
Affiliations

A case of successfully resected metachronous gastric and gallbladder metastases from pancreatic body cancer

Makoto Takahashi et al. Surg Case Rep. .

Abstract

Background: Pancreatic ductal adenocarcinoma (PDAC) readily metastasizes to the lymph nodes, liver, lung, and peritoneum; however, gastric and gallbladder metastases are rare. We report a case of metachronous gastric and gallbladder metastases from PDAC.

Case presentation: The patient is a 71-year-old man who underwent distal pancreatectomy for PDAC. Seventeen months after the surgery, a 30-mm nodule was detected at the lesser curvature of the stomach, which was diagnosed as recurrence of PDAC in the lymph nodes. He then received gemcitabine and S-1 combination chemotherapy for 6 months. Because tumor size remained approximately the same and tumor marker levels decreased, total gastrectomy and cholecystectomy were performed. Pathological examination showed well-differentiated tubular adenocarcinoma in the subserosa and muscularis propria of the stomach and gallbladder. The patient remains alive at 41 months after the second surgery with liver metastasis.

Conclusion: We reported a rare case of metachronous gastric and gallbladder metastases from pancreatic body cancer.

Keywords: Metachronous gallbladder metastasis; Metachronous gastric metastasis; Pancreatic cancer; Surgery.

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Conflict of interest statement

Ethics approval and consent to participate

Not applicable.

Consent for publication

Informed consent was obtained from the patient for the publication of this case report.

Competing interests

The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
Primary operation for pancreatic body cancer. a Multi-detector row computed tomography (MDCT) showed pancreatic body cancer before the first surgery (arrows). b Pathological findings of the primary tumor were as follows: invasive ductal carcinoma, well-differentiated type, and (T3, N0, M0) stage IIa
Fig. 2
Fig. 2
Imaging diagnosis of recurrence. a MDCT showed a 30-mm nodule at the lesser curvature of the stomach. b Positron emission tomography (PET)/CT showed fluorodeoxyglucose (FDG) uptake in the nodule; SUVmax was 3.5. c Upper gastrointestinal endoscopy revealed mucosal irregularity in the posterior wall of the lesser curvature of the gastric body (arrow). d Upper gastrointestinal endoscopy revealed submucosal tumor in the anterior wall of the gastric antrum (arrowhead)
Fig. 3
Fig. 3
Histological findings of metastases. a Macroscopic findings in the stomach. There were two lesions in the stomach wall (arrow: lesser curvature (25 × 20 mm), arrowhead: anterior wall of antrum (15 × 13 mm). b Pathological examination showed well-differentiated tubular adenocarcinoma in the subserosa and muscularis propria of the stomach; the tumor was not exposed to the mucosa and serosa (arrow), and there was no involvement of lymph nodes. c Macroscopic finding in the gallbladder. A 13 × 5-mm submucosal tumor was found in the neck of the gallbladder (arrow). d Well-differentiated tubular adenocarcinoma located in the subserosa of the gallbladder (arrow)
See this image and copyright information in PMC

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