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Case Reports
. 2024 May:118:109588.
doi: 10.1016/j.ijscr.2024.109588. Epub 2024 Mar 28.

Pancreatic cancer with synchronous peritoneal and hepatic metastases: A case report

Antonios-Apostolos Tentes  1 , Dimitrios Kyziridis  2 , Apostolos Kalakonas  2 , Alexandros Iliadis  3 , Anastasia Fotiadou  3
Affiliations
Case Reports

Pancreatic cancer with synchronous peritoneal and hepatic metastases: A case report

Antonios-Apostolos Tentes et al. Int J Surg Case Rep. 2024 May.

Abstract

Introduction and importance: There is evidence that patients with limited peritoneal carcinomatosis of pancreatic cancer or those with low burden of hepatic metastases are amenable to surgical resection. A case report of a patient with cancer of the pancreatic tail and synchronous peritoneal and hepatic metastases is presented.

Case presentation: A male patient, 66 years old, underwent cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) and radio-frequency ablation (RFA) for synchronous hepatic metastases simultaneously to distal pancreatectomy for adenocarcinoma of the pancreas. Adjuvant chemotherapy followed the R0 surgery. The patient remained disease free for 18 months, developed liver recurrence and died 28 months after the initial operation.

Discussion: CRS plus HIPEC with synchronous ablation or resection of hepatic metastases may be used for the treatment of pancreatic cancer with synchronous peritoneal and hepatic metastases in highly selected patients.

Conclusion: Further studies are needed to confirm whether patients with synchronous peritoneal and hepatic metastases are offered survival benefit from complex surgical intervention (CRS plus HIPEC combined with hepatic resection or RFA).

Keywords: Cytoreductive surgery; HIPEC; Hepatic metastases; Pancreatic cancer; Peritoneal metastases; RFA.

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Conflict of interest statement

Declaration of competing interest All authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Preoperative CT. Multiple metastatic hepatic lesions delineated within the hepatic parenchyma. Large volume tumor originating from the tail of the pancreas compressing and probably infiltrating the stomach and the spleen is apparent (right photograph). Large volume seeding is delineated at the right lateral abdominal wall (left photograph).
Fig. 2
Fig. 2
Representative histopathologic findings: 2A: Medium magnification of an area of the primary pancreatic adenocarcinoma. 2B: The tumor cells are diffusely positive for keratin 7. 2C: A tumor cell embolus is seen at this gastric submucosal vein. 2D: Tumor cell invasion of the splenic parenchyma confirming the Fig. 1 findings. (A: hematoxylin-eosin x200, B: immunohistochemistry with streptavidin-biotin x200, C: hematoxylin-eosin x40, D: hematoxylin-eosin X100).
Fig. 3
Fig. 3
Postoperative abdominal CT-scan 12 months after surgery. Two of the ablated hepatic metastatic lesions (left photograph). No implant is delineated at the right lateral abdominal wall (right photograph).
Fig. 4
Fig. 4
Postoperative CT-scan 18 months after initial surgery showing multiple hepatic lesions.
See this image and copyright information in PMC

References

    1. Conroy T., Dessigne F., Ychou M., Bouche V., Guimbau R., Becouarn Y., Adenis A., Roul J.-L., Gourgou-Bourgade S., de la Fouchardiere C., Benouna J., Bachet J.-B., Khemissa-Akouz F., Pere-Verge D., Delbaldo C., Assenat E., Chauffert B., Michel P., Montoro-Grillot C., Ducreux M. Groupe Tumeurs digestives of Unicancer, Prodige intergroup. FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer. N. Engl. J. Med. 2011;364:1817–1825. doi: 10.1056/NEJMoa1011923. - DOI - PubMed
    1. Kindler H.L., Hammel P., Reni M., Van Cutsem E., Macarulla T., Hall M., Park J.-O., Hochhauser D., Arnold D., Oh D.-Y., Reinacher-Schick A., Tortora G., Algul H., O’Reilly E.M., Bordia S., McGuinness D., Cui K., Locker G.Y., Golan T. Overall survival results from the POLO study of active maintenance olaparib versus placebo for germline BRCA-mutated pancreatic cancer. J. Clin. Oncol. 2022;40:3929–3939. doi: 10.1200/JCO.21.01604. - DOI - PMC - PubMed
    1. Gudmundsdottir H., Yonkus J.A., Thiels C.A., Warner S.G., Cleary S.P., Kendrick M.L., Truty M.J., Grotz T.E. Oncologic outcomes of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for highly selected patients with metastatic pancreatic ductal adenocarcinoma. Ann. Surg. Oncol. 2023;30:7833–7839. doi: 10.1245/s10434-023-14138-3. - DOI - PubMed
    1. Tentes A.A., Pallas N., Karamveri C., Kyziridis D., Hristakis C. Cytoreduction and HIPEC for peritoneal carcinomatosis of pancreatic cancer. J. B.U.ON. 2018;23:482–487. - PubMed
    1. Zhou W., Wang D., Lou W. Current role of surgery in pancreatic cancer with synchronous liver metastasis. Cancer Control. 2020;27 doi: 10.1177/1073274820976593. - DOI - PMC - PubMed

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