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Koh, Kim, Jang, Kim, Jin, Kim, Kim, Kim, and Lee: A Case of Non-small Cell Lung Cancer Presenting as Abdominal Pain and a Pancreatic Nodule
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2009; 67(1): 42-46.

Published online: 31 July 2009

DOI: https://doi.org/10.4046/trd.2009.67.1.42

A Case of Non-small Cell Lung Cancer Presenting as Abdominal Pain and a Pancreatic Nodule

Kyung Won Koh, M.D.1, Hyeon Tae Kim, M.D.1, Sang Eon Jang, M.D.1, Yeo Myeong Kim, M.D.1, Min-Sun Jin, M.D.2, Sang Bum Kim, M.D.3, Hye-Ryoun Kim, M.D.1, Cheol Hyeon Kim, M.D.1, Jae Cheol Lee, M.D.1

1Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea.

2Department of Pathology, Korea Cancer Center Hospital, Seoul, Korea.

3Department of General Surgery, Korea Cancer Center Hospital, Seoul, Korea.

Address for correspondence: Jae Cheol Lee, M.D. Department of Internal Medicine, Korea Cancer Center Hospital, 215-4, Gongneung-dong, Nowon-gu, Seoul 139-706, Korea. Phone: 82-2-970-1206, Fax: 82-2-970-2438 jclee@kcch.re.kr

Received 4 June 2009       Accepted 30 June 2009

Copyright©2009. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.

Abstract

Lung cancer frequently metastasizes to distant organs. However, solitary metastasis to the pancreas, with lung cancer as the source, is very rare. Most metastatic cases of the pancreas tend to be discovered in patients with widely disseminated malignant disease. In addition, patients with pancreatic metastases are often asymptomatic, the metastatic lesions are found incidentally, and are misdiagnosed as primary pancreatic tumors. We described the case of a 63-year-old man who presented with abdominal pain and a pancreatic nodule. The patient underwent resection of primary lung cancer followed by pylorus preserving pancreatoduodenectomy. The pancreatic nodule was confirmed as a solitary metastasis from lung cancer.

Keywords: Lung neoplasms, Solitary pancreatic metastasis, Abdominal pain

Figures and Tables

Figure 1
(A) Abdomen-pelvic CT showed an about 8 mm-sized nodule (arrow) in pancreas head with mildly dilated pancreatic duct. (B) 18FDG-PET scan revealed diffuse and nodular hypermetabolic lesion (arrow) in pancreas.
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Figure 2
A 4.8 cm-sized airspace opacity was detected in left lower lung on chest CT.
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Figure 3
Pathologic examination of biopsied specimen from lung showed that the tumor consisted of sheets or nests of large polygonal cells with vesicular nuclei with prominent nucleoli, and a moderate amount of cytoplasm indicating large cell carcinoma. A few multinucleated giant cells were also found (H&E stain, ×400).
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Figure 4
(A) An about 2 cm-sized, poorly demarcated infiltrative, yellowish tan, granular and firm tumor was grossly observed within pancreas. (B) Similar pathologic findings with the lung cancer were noted in pancreatic tumor confirming that it was originated from lung cancer (H&E stain, ×400).
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