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International Cancer Conference Journal

, Volume 8, Issue 4, pp 190–194 | Cite as

Incidental abdominal lymph node metastases from a known breast cancer in resected specimen of invasive pancreatic ductal adenocarcinoma: report of a case

  • Tomohiko TaniaiEmail author
  • Koichiro Haruki
  • Michinori Matsumoto
  • Taro Sakamoto
  • Hiroaki Shiba
  • Katsuhiko Yanaga
Case report
  • 11 Downloads

Abstract

Breast cancer is known to metastasize to all organs of the body. However, abdominal lymph node metastases from breast cancer are extremely rare. We herein report a resected case of an invasive pancreatic ductal adenocarcinoma (PDAC) in which abdominal lymph node metastases from breast cancer were diagnosed. A 54-year-old woman was pointed out to have a tumor in the pancreatic tail with dilatation of the distal pancreatic duct. She had undergone partial mastectomy for left breast cancer at the age of 51 years and had undergone partial liver resection for liver metastasis in the segment 3/4 6 months earlier. Computed tomography revealed a low-density tumor in the pancreatic tail with dilated distal main pancreatic duct. Magnetic resonance imaging (MRI) exhibited a high-intensity tumor in the pancreatic tail in diffusion-weighted images. With a diagnosis of pancreatic cancer, distal pancreatectomy and splenectomy with lymph nodes dissection was performed. Lymph node metastases along the splenic artery were pathologically similar to PDAC. However, lymph node metastases along the left gastric artery, common hepatic artery, celiac axis, and superior mesenteric artery were pathologically similar to breast cancer. Immunohistochemistry staining of abdominal lymph nodes with GATA-3 was positive, which strongly suggested metastatic breast cancer. Although she received chemotherapy with S-1 for breast cancer and PDAC for 4 months, MRI showed multiple liver metastases derived from breast cancer. Finally, she died 12 months after operation.

Keywords

Pancreatic ductal adenocarcinoma Abdominal lymph node metastases Breast cancer 

Abbreviations

PDAC

Pancreatic ductal adenocarcinoma

IHC

Immunohistochemistry

ER

Estrogen receptor

PgR

Progesterone receptor

HER2

Human epithelial growth factor receptor type 2

GATA-3

GATA-binding protein 3

CEA

Carcinoembryonic antigen

CA19-9

Carbohydrate antigen 19-9

DUPAN-2

Duke-Pancreas-2

CT

Computed tomography

MRI

Magnetic resonance imaging

EUS

Endoscopic ultrasound

MPD

Main pancreatic duct

DP

Distal pancreatectomy

UICC

Union for international cancer control

PET

Positron emission tomography

Notes

Author contributions

TT, KH, MM, TS, and HS drafted the manuscript. KY has given the final approval of the version to be published. All the authors read and approved the final manuscript.

Funding

None.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interest.

Ethics approval and consent to participate

Not applicable.

Consent for publication

Written informed consent was obtained from the patients for publication of this case report and any accompanying images.

Availability of data and materials

Not applicable.

References

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Copyright information

© The Japan Society of Clinical Oncology 2019

Authors and Affiliations

  1. 1.Department of SurgeryThe Jikei University School of MedicineTokyoJapan

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