A resected case of pancreatic metastasis from lung cancer, preoperatively diagnosed by ERP-guided biopsy

A 56-year-old man who had undergone right pneumoresection for lung cancer and resection of metastasis to the brain was referred to us for further examination of a pancreas tail tumor. Follow-up CT showed a well-demarcated, growing tumor with a central low-attenuation area in the pancreas tail. ERP showed interrupted occlusion of the main pancreatic duct in the tail and EPR-guided biopsy was conducted from this lesion. Biopsied specimens suggested lung cancer metastasis in immunohistochemical staining, so we conducted distal pancreatectomy. Final histological findings were compatible with lung cancer metastasis. The man has remained well without evidence of recurrence in the 14 months since surgery. Surgical management may thus be an optimal option in treating metastatic pancreatic tumor when secondary tumors are limited to the pancreas with the controlled primary tumor.