Pancreatectomy as a form of treatment for leiomyosarcoma metastasis to pancreas — case report and literature review

Abstract

Background: Pancreatic cancers represent about 2% of all malignant tumors. The prognosis for patients is rather poor and the five-year survival is only 9%. Metastases constitute 2–5% of this organ’s tumors, and the management of such cases is determined individually depending on the type of cancer, the patient’s condition and the medical center’s experience. We present a rare case of pancreatic metastasis from a subcutaneous leiomyosarcoma.

Case: A 71-year-old woman with history of leiomyosarcoma — six years ago, two cancer outbreaks, located in the subcutaneous tissue of the thigh and shoulder treated by surgery and adjuvant radiotherapy. After 5 years, a lung metastasis was diagnosed and successfully resected. The following year, CT scan revealed a mass in the pancreas. The patient also complained of epigastric pain and bloating. The biopsy of the lesion confirmed leiomyosarcoma metastasis. The patient underwent 6 cycles of ADIC chemotherapy, after which the tumor size decreased and the laparotomy was performed. The metastasis was well-demarcated and did not infiltrate surrounding tissues, so distal pancreatectomy provided a complete tumor resection There were no complications throughout surgery During 12 months follow up no recurrence was observed.

Conclusions: Due to the relatively rare occurrence, standards for the treatment of pancreatic metastases have not been developed yet. This case shows that treatment by resection of the tumor while maintaining a surgical margin can be considered as a form of treatment in pancreatic secondary cancers.