Colon Metastasis from Pancreatic Cancer: A Case Report

Abstract

Pancreatic cancer commonly metastasizes to the liver, lung or adrenal glands, but rarely spreads to the colon. We describe a case of a 65-year-old man with operation history of endoscopic submucosal dissection for rectal adenoma, who visited our department with a lesion in the sigmoid colon. A biopsy of the sigmoid pathologic lesion found heterologous cells in the muscularis mucosa, which indicated that this lesion did not originate in the colon. Abdominal enhanced CT results revealed a soft tissue mass in pancreatic tail and several masses in the liver and rectovesical pouch. 18-FDG PET-scan results showed pancreatic neoplastic mass. Biopsy result of pancreatic pathologic area was positive for ductal pancreatic adenocarcinoma. Immunohistochemical staining confirmed that the sigmoid lesion was a metastasis from a primary pancreatic adenocarcinoma—an unusual pattern of spread. The patient accepted chemotherapy after an oncologic evaluation. To our knowledge, there were only nine reported cases of metastatic pancreatic cancer spreading to the colon. This was a rare route of metastasis for pancreatic cancer. It is important to keep this possibility in mind when patients present with a colon lesion. Furthermore, our case highlights the importance of considering metastases when a colon mass is found in patients with a history of colon cancer, although primary colon cancer is still more likely.

Keywords:

• pancreatic cancer
• colon cancer
• sigmoid colon
• colon metastasis
• case report

Ethics Approval and Consent to Participate

Ethical review and approval were not required for the study on human participants in accordance with local legislation and institutional requirements. The patient provided their written informed consent to participate in this study. Written informed consent was obtained from the individual(s) for the publication of any potentially identifiable images or data included in this article.

Acknowledgments

We gratefully thank all members of the Department of Gastroenterology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology for helping with this study.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; and gave final approval for the version to be published. All authors have agreed on the journal to which the article has been submitted, and agree to be accountable for all aspects of the work.

Disclosure

The authors declare no conflicts of interest.

Additional information

Funding

There is no funding to report.