Simultaneous brain and lung metastases of pancreatic ductal adenocarcinoma after curative pancreatectomy: a case report and literature review View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2021-01-06

AUTHORS

Yoshito Oka, Shigetsugu Takano, Yusuke Kouchi, Katsunori Furukawa, Tsukasa Takayashiki, Satoshi Kuboki, Daisuke Suzuki, Nozomu Sakai, Shingo Kagawa, Isamu Hosokawa, Takashi Mishima, Takanori Konishi, Takashi Kishimoto, Masayuki Ohtsuka

ABSTRACT

BackgroundPancreatic ductal adenocarcinoma (PDAC) rarely metastasizes to the brain; therefore, the features of brain metastasis of PDAC are still unknown. We encountered simultaneous metastases to the brain and lung in a PDAC patient after curative surgery.Case presentationA 68-year-old man with PDAC in the tail of the pancreas underwent distal pancreato-splenectomy. He received gemcitabine as adjuvant chemotherapy for 6 months. Two months later, brain and lung metastases occurred simultaneously. Considering the systemic condition, the patient received gamma knife treatment and an Ommaya reservoir was inserted for drainage. The patient’s condition gradually worsened and he received the best supportive care. To the best of our knowledge, only 28 cases in which brain metastases of PDAC were identified at the time of ante-mortem have been reported to date, including the present case. Notably, the percentage of simultaneous brain and lung metastases was higher (32%) in a series of reviewed cohorts. Thus, lung metastasis might be one of the risk factors for the development of brain metastasis in patients with PDAC. As a systemic disease, it can be inferred that neoplastic cells will develop brain metastasis via hematogenous dissemination beyond the blood–brain barrier, even if local recurrence is controlled. In our case, immunohistochemical staining showed that the neoplastic cells were positive for carbonic anhydrase 9 (CAIX), mucin core protein 1 (MUC1), and MUC5AC in the resected primary PDAC.ConclusionWe describe a case of simultaneous brain and lung metastases of PDAC after curative pancreatectomy, review previous literature, and discuss the clinical features of brain metastasis of PDAC. More... »

PAGES

9

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s12876-020-01587-3

DOI

http://dx.doi.org/10.1186/s12876-020-01587-3

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1134387371

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/33407200


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23 schema:description BackgroundPancreatic ductal adenocarcinoma (PDAC) rarely metastasizes to the brain; therefore, the features of brain metastasis of PDAC are still unknown. We encountered simultaneous metastases to the brain and lung in a PDAC patient after curative surgery.Case presentationA 68-year-old man with PDAC in the tail of the pancreas underwent distal pancreato-splenectomy. He received gemcitabine as adjuvant chemotherapy for 6 months. Two months later, brain and lung metastases occurred simultaneously. Considering the systemic condition, the patient received gamma knife treatment and an Ommaya reservoir was inserted for drainage. The patient’s condition gradually worsened and he received the best supportive care. To the best of our knowledge, only 28 cases in which brain metastases of PDAC were identified at the time of ante-mortem have been reported to date, including the present case. Notably, the percentage of simultaneous brain and lung metastases was higher (32%) in a series of reviewed cohorts. Thus, lung metastasis might be one of the risk factors for the development of brain metastasis in patients with PDAC. As a systemic disease, it can be inferred that neoplastic cells will develop brain metastasis via hematogenous dissemination beyond the blood–brain barrier, even if local recurrence is controlled. In our case, immunohistochemical staining showed that the neoplastic cells were positive for carbonic anhydrase 9 (CAIX), mucin core protein 1 (MUC1), and MUC5AC in the resected primary PDAC.ConclusionWe describe a case of simultaneous brain and lung metastases of PDAC after curative pancreatectomy, review previous literature, and discuss the clinical features of brain metastasis of PDAC.
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29 schema:keywords BackgroundPancreatic ductal adenocarcinoma
30 Case presentationA
31 ConclusionWe
32 Ommaya reservoir
33 PDAC
34 PDAC patients
35 adenocarcinoma
36 adjuvant chemotherapy
37 barriers
38 blood-brain barrier
39 brain
40 brain metastases
41 carbonic anhydrase 9
42 care
43 case report
44 cases
45 cells
46 chemotherapy
47 clinical features
48 cohort
49 conditions
50 core protein 1
51 curative pancreatectomy
52 curative surgery
53 date
54 development
55 disease
56 dissemination
57 drainage
58 ductal adenocarcinoma
59 factors
60 features
61 gamma knife treatment
62 gemcitabine
63 hematogenous dissemination
64 immunohistochemical staining
65 knowledge
66 literature
67 literature review
68 local recurrence
69 lung
70 lung metastases
71 men
72 metastasis
73 months
74 mucin core protein 1
75 neoplastic cells
76 pancreas
77 pancreatectomy
78 pancreatic ductal adenocarcinoma
79 patient's condition
80 patients
81 percentage
82 present case
83 previous literature
84 primary PDAC
85 protein 1
86 recurrence
87 report
88 reservoir
89 review
90 risk factors
91 series
92 simultaneous brain
93 simultaneous metastases
94 staining
95 supportive care
96 surgery
97 systemic conditions
98 systemic disease
99 tail
100 time
101 treatment
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