Long-term survival after repeated resection of metachronous lung metastases from pStage IA pancreatic adenocarcinoma
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A 70-year-old woman with pancreatic ductal adenocarcinoma was initially treated by distal pancreatectomy (DP). Thirty-five months later, another tumor appeared in the pancreatic head and was treated by pancreaticoduodenectomy. Histopathological findings identified both tumors as pancreatic ductal adenocarcinoma pStage IA. Computed tomography (CT) of the chest 16 months after the second pancreatectomy revealed a ground-glass opacity in segment 3 of the right lung. Chest CT 23 months after the second pancreatectomy revealed a nodular shadow in segment 1a of the right lung. Chest CT 39 months after the second pancreatectomy revealed a nodular shadow in segment 5 of the left lung. These lesions were treated by video-assisted thoracoscopic surgery partial resection. Histopathological and immunohistochemical features (positive for cytokeratin (CK)7 and CK20, negative for transcription factor-1) for these three lesions and the secondary pancreatic ductal adenocarcinoma were similar, indicating a diagnosis of lung metastasis from the second pancreatic ductal adenocarcinoma. The patient has remained alive and free of new metastases for 8 years after initial DP, 3 years after the last lung resection.
This patient has survived over the long term after undergoing three resections of lung metastases from resected pancreatic ductal adenocarcinoma.
KeywordsPancreatic ductal adenocarcinoma Lung metastasis Lung resection Long-term survival
Compliance with ethical standards
Conflict of interest
Mamoru Miyasaka, Takehiro Noji, Kazuto Ohtaka, Ryohei Chiba, Shoki Sato, Yasuhito Shoji, Ryunosuke Hase, Tatsunosuke Ichimura, Satoshi Hirano, and Naoto Senmaru declares that they have no conflict of interest.
All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.
Informed consent was obtained from all patients for being included in the study.
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