Tuberc Respir Dis.  2009 Jul;67(1):42-46.

A Case of Non-small Cell Lung Cancer Presenting as Abdominal Pain and a Pancreatic Nodule

• Koh KW
• Kim HT
• Jang SE
• Kim YM
• Jin MS
• Kim SB
• Kim HR
• Kim CH
• Lee JC

Abstract

Lung cancer frequently metastasizes to distant organs. However, solitary metastasis to the pancreas, with lung cancer as the source, is very rare. Most metastatic cases of the pancreas tend to be discovered in patients with widely disseminated malignant disease. In addition, patients with pancreatic metastases are often asymptomatic, the metastatic lesions are found incidentally, and are misdiagnosed as primary pancreatic tumors. We described the case of a 63-year-old man who presented with abdominal pain and a pancreatic nodule. The patient underwent resection of primary lung cancer followed by pylorus preserving pancreatoduodenectomy. The pancreatic nodule was confirmed as a solitary metastasis from lung cancer.

Keyword

Lung neoplasms; Solitary pancreatic metastasis; Abdominal pain

MeSH Terms

Abdominal Pain
Carcinoma, Non-Small-Cell Lung
Humans
Lung Neoplasms
Middle Aged
Neoplasm Metastasis
Pancreas
Pancreaticoduodenectomy
Pylorus

Figure

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  Figure 1 (A) Abdomen-pelvic CT showed an about 8 mm-sized nodule (arrow) in pancreas head with mildly dilated pancreatic duct. (B) 18FDG-PET scan revealed diffuse and nodular hypermetabolic lesion (arrow) in pancreas.

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  Figure 2 A 4.8 cm-sized airspace opacity was detected in left lower lung on chest CT.

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  Figure 3 Pathologic examination of biopsied specimen from lung showed that the tumor consisted of sheets or nests of large polygonal cells with vesicular nuclei with prominent nucleoli, and a moderate amount of cytoplasm indicating large cell carcinoma. A few multinucleated giant cells were also found (H&E stain, ×400).

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  Figure 4 (A) An about 2 cm-sized, poorly demarcated infiltrative, yellowish tan, granular and firm tumor was grossly observed within pancreas. (B) Similar pathologic findings with the lung cancer were noted in pancreatic tumor confirming that it was originated from lung cancer (H&E stain, ×400).

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