Distal Pancreatectomy for Isolated Metastasis of Endometrial Carcinoma to the Pancreas

摘要

Context The majority of oncological pancreatic resections involve resection of primary pancreatic tumors. Pancreatic resection for metastatic disease is rare but can produce durable palliation or even cure in carefully selected patients. Herein, we report what to our knowledge is the first description of pancreatic resection of metastatic endometrial carcinoma. Case report We evaluated a patient who developed a mass in the distal pancreas as identified by screening computed tomography nearly three years after radical abdominal hysterectomy, bilateral salpingooophorectomy, and bilateral pelvic and paraaortic lymph node dissection for an International Federation of Gynecology and Obstetrics stage IIIA, grade 2 endometrial cancer. Findings on cytopathologic examination of tissue obtained by fine needle aspiration of the lesion were consistent with metastatic endometrial carcinoma. Radiographic imaging and physical examination failed to identify additional sites of disease. After receiving counseling as to the risks and projected benefits of surgical resection, the patient underwent a distal pancreatectomy, splenectomy, and partial gastrectomy with en bloc excision of the tumor. On final pathologic examination, all margins were free of tumor. At the time of this report, the patient remains without evidence of disease. Conclusion Metastasis to the pancreas from endometrial cancer is uncommon; however, this possibility should be considered in patients with a new pancreatic lesion and a history of endometrial cancer as pancreatic resection of metastatic disease can benefit selected patients.