Pericleous Stephanos, Mukherjee Samrat, Hutchins Robert R
Department of HPB Surgery, Imperial College, Hammersmith Hospital campus, London, UK.
World J Surg Oncol. 2008 Nov 11;6:120. doi: 10.1186/1477-7819-6-120.
Lung cancer is known to metastasize to the pancreas with several case reports found in the literature, however, most patients are at an advanced stage and receive palliative treatment.
We describe the case of a 56 year old male patient who presented with a picture of obstructive jaundice. Investigations revealed an obstructing lesion in the pancreas and a further lesion in the lung with benign appearances. The patient underwent a pancreatectomy and, unexpectedly, the histology of the resected specimen demonstrated metastatic adenocarcinoma of bronchogenic origin. He was referred to a cardiothoracic team who proceeded to resect the patient's thoracic lesion before administration of adjuvant chemotherapy. The patient was reviewed 18 months post operatively and remains symptom free with no clinical or radiological evidence of recurrence. We were unable to identify any previous case reports (of lung adenocarcinoma) with such a presentation which were ultimately treated with resection of both lesions.
Similar situations are bound to arise again in the future and we believe that this report could demonstrate that there is a case for aggressive surgical management in a highly selected group of patients: those with NSCLC and a synchronous solitary pancreatic deposit.
肺癌转移至胰腺已有数篇病例报告见于文献，然而，大多数患者处于晚期并接受姑息治疗。
我们描述了一名56岁男性患者的病例，该患者表现为梗阻性黄疸。检查发现胰腺有梗阻性病变，肺部有另一个外观呈良性的病变。患者接受了胰腺切除术，出乎意料的是，切除标本的组织学检查显示为支气管源性转移性腺癌。他被转诊至心胸外科团队，该团队在给予辅助化疗前对患者的胸部病变进行了切除。患者术后18个月接受复查，仍无症状，无临床或影像学复发证据。我们未能找到之前有此类表现（肺腺癌）且最终通过切除两个病变进行治疗的病例报告。
类似情况未来必然会再次出现，我们认为本报告可以表明，在经过严格挑选的一组患者中，即非小细胞肺癌患者和同步出现的孤立性胰腺转移灶患者，有积极手术治疗的理由。
