Surgical Resection of a Solitary Pancreatic Metastasis from Colorectal Cancer: A New Step to a Cure?

被引:8
作者
Gravalos, Cristina [1 ]
Garcia-Sanchez, Lourdes [1 ]
Hernandez, Marta [1 ]
Holgado, Esther [1 ]
Alvarez, Natalia [1 ]
Garcia-Escobar, Ignacio [1 ]
Martinez, Joaquin [2 ]
Robles, Luis [3 ]
机构
[1] Univ Hosp 12 Octubre, Dept Med Oncol, Madrid 28041, Spain
[2] Univ Hosp 12 Octubre, Mol Pathol Lab, Dept Haematol, Madrid 28041, Spain
[3] Univ Hosp 12 Octubre, Genet Counselling Unit, Dept Med Oncol, Madrid 28041, Spain
关键词
Hereditary cancer; Mismatch repair gene; mutS homologue; Neoadjuvant chemotherapy;
D O I
10.3816/CCC.2008.n.053
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Isolated metastases to the pancreas from colorectal cancer (CRC) are very rare. We report a case of a 37-year-old man with a hereditary nonpolyposis CRC with a solitary metastasis to the pancreas who was treated with right hemicolectomy, neoadjuvant chemotherapy, complete surgical resection of the pancreatic metastasis, and adjuvant chemotherapy. After 12 months of follow-up, the patient remains free of disease. Differential diagnosis of isolated metastasis to the pancreas should be performed with pancreatic primary adenocarcinomas and neuroendocrine tumors. Symptoms and signs might be similar in these diseases: pain, weight loss, obstructive jaundice, and duodenal obstruction. Nevertheless, both primary and secondary tumors might be totally asymptomatic. Imaging techniques such as computed tomography, ultrasonography, magnetic resonance imaging, positron emission tomography, or endoscopic retrograde colangiopancreatography can provide relevant information about pancreatic lesions. However, it remains difficult to distinguish primary from metastatic pancreatic tumors. Although there is currently very limited experience with the surgical resection of isolated pancreatic metastases from CRC, it should be considered in selected patients with low surgical risk in order to prolong progression-free survival and overall survival. Additional chemotherapy is recommended.
引用
收藏
页码:398 / 401
页数:4
相关论文
共 26 条
[11]   Mismatch repair status in the prediction of benefit from adjuvant fluorouracil chemotherapy in colorectal cancer [J].
Jover, R. ;
Zapater, P. ;
Castells, A. ;
Llor, X. ;
Andreu, M. ;
Cubiella, J. ;
Pinol, V. ;
Xicola, R. M. ;
Bujanda, L. ;
Rene, J. M. ;
Clofent, J. ;
Bessa, X. ;
D Morillas, J. ;
Nicolas-Perez, D. ;
Paya, A. ;
Alenda, C. .
GUT, 2006, 55 (06) :848-855
[12]   Patterns of cancer incidence, mortality, and prevalence across five continents: Defining priorities to reduce cancer disparities in different geographic regions of the world [J].
Kamangar, Farin ;
Dores, Graca M. ;
Anderson, William F. .
JOURNAL OF CLINICAL ONCOLOGY, 2006, 24 (14) :2137-2150
[13]   PANCREATIC-CARCINOMA AND HEREDITARY NONPOLYPOSIS COLORECTAL-CANCER - A FAMILY STUDY [J].
LYNCH, HT ;
VOORHEES, GJ ;
LANSPA, SJ ;
MCGREEVY, PS ;
LYNCH, JF .
BRITISH JOURNAL OF CANCER, 1985, 52 (02) :271-273
[14]   Cellular effects of CPT-11 on colon carcinoma cells:: Dependence on p53 and hMLH1 status [J].
Magrini, R ;
Bhonde, MR ;
Hanski, RL ;
Notter, M ;
Scherübl, H ;
Boland, CR ;
Zeitz, M ;
Hanski, C .
INTERNATIONAL JOURNAL OF CANCER, 2002, 101 (01) :23-31
[15]   Pancreaticoduodenectomy for metastatic tumors to the periampullary region [J].
Medina-Franco, H ;
Halpern, NB ;
Aldrete, JS .
JOURNAL OF GASTROINTESTINAL SURGERY, 1999, 3 (02) :119-122
[16]  
Pereira-Lima JC, 2000, HEPATO-GASTROENTEROL, V47, P554
[17]  
PLASENCIA C, 2000, P AN M AM SOC CLIN, V19, pA204
[18]  
RONALD CF, 1989, SURG GYNECOL OBSTET, V168, P345
[19]  
Shimoda M, 2007, HEPATO-GASTROENTEROL, V54, P1262
[20]   Metastatic disease to the pancreas and spleen [J].
Showalter, Shayna L. ;
Hager, Eric ;
Yeo, Charles J. .
SEMINARS IN ONCOLOGY, 2008, 35 (02) :160-171