Colonic and anal metastases from pancreato-biliary malignancies

Metastatic Cholangiocarcinoma Presenting as Colonic Obstruction

Cholangiocarcinoma (CCA) is a biliary epithelial cancer conferring a grim prognosis. Metastatic recurrence of CCA is often discovered because of symptoms stemming from the site of metastasis. It is rarely reported that colonic obstruction serves as the presenting symptom of disease recurrence. We report the unusual discovery of malignant colonic obstruction because of metastatic CCA. Our report highlights the benefit of minimally invasive colonic stenting for palliation yielding immediate relief of pain while avoiding untoward sequelae from high-risk surgical intervention.

Surgical resection of hepatic and rectal metastases of pancreatic acinar cell carcinoma (PACC): a case report

Background

Pancreatic acinar cell carcinoma (PACC), a rare variant of pancreatic malignancy, is generally managed the same way as pancreatic ductal adenocarcinoma (PDAC). Surgical resection is the gateway to curing it; however, once it metastasizes (usually to the liver, lungs, lymph nodes, or peritoneal cavity), systemic chemotherapy has been the only option, but with unfavorable results.

Case presentation

A 67-year-old man with symptoms of loss of appetite and weight underwent surgery for malignancy of the pancreatic tail extending into the entire pancreas. The pathological diagnosis was PACC following total pancreatectomy. Twenty-four months after the pancreatectomy, a solitary liver metastasis was treated by partial hepatectomy, and, subsequently, 4 months later, he presented with melena. Further examination revealed a type-2 rectal tumor. Histological examination following biopsy revealed it to be rectal metastasis of PACC, and it was treated by abdominoperineal resection. Subsequently, the patient did not have tumor recurrence as of 40 months after pancreatectomy.

Conclusions

This is a rare case of PACC presenting with metachronal metastases in the liver and rectum, and we successfully treated them by surgical resections. Since the malignant behavior of PACC is usually less than that of PDAC, surgical resection could be an option even for metastatic lesions when the number and extent of metastases are limited.

Rare occurrence of metastasis from lung cancer to the anus: case report and review of the literature

Background

Anal metastases from lung cancer are infrequent, and there are only 10 published cases. Life expectancy is no longer than 1 year after diagnosis because of the typically advanced stage of disease. Treatment, which is typically inefficient, is administered with the intent to cure or avoid local complications.

Case presentation

We report a case of a patient with non-small cell lung cancer presenting with perianal metastasis mimicking an abscess.

Conclusions

Because perianal masses may be misdiagnosed, patients with lung and other cancers should be evaluated for metastatic disease.