YO2 - Metastatic pancreatic cancer originating from invasive ductal carcinoma mimicking primary pancreatic cancer: A case report

Date 18 December 2016
Event ESMO Asia 2016 Congress
Session Poster lunch
Topics Breast Cancer, Metastatic
Presenter Jong Lee
Authors J.E. Lee, S. Han, S. Park, S. Kim
  • Surgery, Soon Chun Hyang University Hospital , Cheonan, 330-721 - Cheonan/KR


Case Summary

Introduction: Breast cancer can metastasize to local or regional sites or distant organs. Breast cancer metastasis is associated with tumor staging at the time of diagnosis. Furthermore, several histological and biological characteristics are involved. In particular, distant metastasis has been reported to occur more frequently in hormone receptor negative cases. Distant metastasis of breast cancer can occur in any part of the body, but the most common sites of metastasis are the bone, lungs, and liver. Therefore, physicians should always consider metastasis in the whole body.

Methods: A 64-year old woman underwent breast-conserving surgery with sentinel lymph node biopsy for primary operable malignancy. According to hormone receptor results, she was taking tamoxifen. During a routine checkup, we found a mass in the pancreas. We performed a biopsy on the pancreatic mass. The biopsy confirmed that the mass was most probably adenocarcinoma.

Results: We performed surgical excision of the pancreatic mass. It was confirmed as poorly differentiated adenocarcinoma. It was 1.8 cm in size and no lymph node metastasis. ER, PR and HER2/neu immunohistochemistry staining were negative. It was thought to be primary pancreatic cancer and, so, adjuvant chemotherapy was begun. One year after pancreatic surgery, we found a new lung nodule. We performed a PTNB on that nodule. The pathologic report confirmed that the lung nodule had metastasized from the original breast cancer. In addition, it did not have a good response to adjuvant treatment. So, we conducted a review of the pancreas mass and concluded that it was also metastatic pancreatic cancer from the breast.

Conclusions: The most common metastatic sites of breast cancer are the bones, lungs, liver. However, distant metastasis of breast cancer can occur in any part of the body. We experienced metastatic pancreatic cancer mimicking primary pancreatic cancer. It is necessary to make more of an effort to determine the precise results after an operation. Depending on such results, physicians can tell the difference between primary and metastatic cancer and, thus, devise an appropriate treatment regimen.

Keywords: Breast cancer, Metastasis, Pancreas