Resected Metastatic Pancreatic Cancer 13 Years after Surgery for Ascending Colon Cancer

We report a case of resected metastatic pancreatic cancer 13 years after surgery for ascending colon cancer. The patient was a 75-year-old woman who underwent a right hemicolectomy for ascending colon cancer 13 years previously that was diagnosed as a well-differentiated adenocarcinoma: SS, ly2, v1, N1, H0, P0, M0, Stage IIIa. After surgery, the patient received follow-up care from her local doctor. A follow-up blood examination 13 years later showed elevated tumor markers, and an abdominal CT scan revealed a mass at the pancreatic tail. The patient was subsequently referred to our department for further examination and treatment. After hospitalization, an enhanced CT scan of the abdomen revealed a mass of approximately 20 mm in diameter in the pancreatic tail. We diagnosed pancreatic tail cancer. A distal pancreatectomy with splenectomy was performed. Immunohistochemistry showed that the tumor antigen expression profile was negative for cytokeratin 7 and positive for cytokeratin 20 and mucin 2. These results indicated that the tumor was a metachronous pancreatic metastasis from the prior colon cancer. The postoperative course was uneventful, and the patient was discharged on postoperative day 27. Twenty-four months have passed after surgery, and the patient is well without any recurrence.