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Acute cholangitis due to pancreatic metastasis from squamous cell lung carcinoma: a case report and review of literature

INTRODUCTION: The pancreas is a well-documented but relatively uncommon site of non-small-cell cancer metastases. However, at the time of diagnosis the disease is usually locoregionally advanced, therefore therapeutic management is mostly palliative and symptomatic. CASE PRESENTATION: We report the...

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Autores principales: Kyriazi, Maria A, Sofoudis, Chrisostomos, Katsouri, Maria, Kappos, Theocharis, Zafeiris, Christos, Trihia, Eleni, Diamantopoulos, Pantelis, Nomikos, Iakovos N
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2803910/
https://www.ncbi.nlm.nih.gov/pubmed/20062690
http://dx.doi.org/10.1186/1757-1626-2-9113
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author Kyriazi, Maria A
Sofoudis, Chrisostomos
Katsouri, Maria
Kappos, Theocharis
Zafeiris, Christos
Trihia, Eleni
Diamantopoulos, Pantelis
Nomikos, Iakovos N
author_facet Kyriazi, Maria A
Sofoudis, Chrisostomos
Katsouri, Maria
Kappos, Theocharis
Zafeiris, Christos
Trihia, Eleni
Diamantopoulos, Pantelis
Nomikos, Iakovos N
author_sort Kyriazi, Maria A
collection PubMed
description INTRODUCTION: The pancreas is a well-documented but relatively uncommon site of non-small-cell cancer metastases. However, at the time of diagnosis the disease is usually locoregionally advanced, therefore therapeutic management is mostly palliative and symptomatic. CASE PRESENTATION: We report the case of a 77-year-old Caucasian male patient who presented initially with a clinical picture of acute cholangitis approximately 2 years after a left lower lobectomy for a low-grade squamous lung carcinoma. CT scan imaging of the abdomen and chest revealed an abnormal growth of the pancreatic head and distention of both the intra- and extra-hepatic billiary tree, whereas osteolytic abnormalities were observed of the 5th left rib, consistent with secondary deposits. Initially an endoscopic retrograde cholangio-pancreatography (ERCP) and sphincterectomy was performed and a plastic stent was placed in the common bile duct to decompress the biliary tree. Cytological examination of the aspirate collected by FNA of the pancreatic lession under EUS guidance revealed cells consistent with a low grade squamous lung carcinoma. Two months later an open cholecystectomy along with a gastrojejunostomy was performed to relieve the patient's gastric outlet obstruction symptoms. Following remission of the patient's attack of acute cholangitis and excessive vomiting he was released from the hospital and instructed to initiate chemotherapy with vinorelbine. The patient succumbed to disseminated disease almost 5 months later. CONCLUSION: Symptomatic metastatic lesions of the pancreas from squamous cell carcinoma of the lung are infrequent. Typically, the patients remain asymptomatic until their disease reaches a fairly advanced stage and therapeutic options are limited to palliative measures. A high index of suspicion is the only way of early detection and potentially effective treatment for this rare localization of metastatic squamous lung carcinoma.
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spelling pubmed-28039102010-01-10 Acute cholangitis due to pancreatic metastasis from squamous cell lung carcinoma: a case report and review of literature Kyriazi, Maria A Sofoudis, Chrisostomos Katsouri, Maria Kappos, Theocharis Zafeiris, Christos Trihia, Eleni Diamantopoulos, Pantelis Nomikos, Iakovos N Cases J Case Report INTRODUCTION: The pancreas is a well-documented but relatively uncommon site of non-small-cell cancer metastases. However, at the time of diagnosis the disease is usually locoregionally advanced, therefore therapeutic management is mostly palliative and symptomatic. CASE PRESENTATION: We report the case of a 77-year-old Caucasian male patient who presented initially with a clinical picture of acute cholangitis approximately 2 years after a left lower lobectomy for a low-grade squamous lung carcinoma. CT scan imaging of the abdomen and chest revealed an abnormal growth of the pancreatic head and distention of both the intra- and extra-hepatic billiary tree, whereas osteolytic abnormalities were observed of the 5th left rib, consistent with secondary deposits. Initially an endoscopic retrograde cholangio-pancreatography (ERCP) and sphincterectomy was performed and a plastic stent was placed in the common bile duct to decompress the biliary tree. Cytological examination of the aspirate collected by FNA of the pancreatic lession under EUS guidance revealed cells consistent with a low grade squamous lung carcinoma. Two months later an open cholecystectomy along with a gastrojejunostomy was performed to relieve the patient's gastric outlet obstruction symptoms. Following remission of the patient's attack of acute cholangitis and excessive vomiting he was released from the hospital and instructed to initiate chemotherapy with vinorelbine. The patient succumbed to disseminated disease almost 5 months later. CONCLUSION: Symptomatic metastatic lesions of the pancreas from squamous cell carcinoma of the lung are infrequent. Typically, the patients remain asymptomatic until their disease reaches a fairly advanced stage and therapeutic options are limited to palliative measures. A high index of suspicion is the only way of early detection and potentially effective treatment for this rare localization of metastatic squamous lung carcinoma. BioMed Central 2009-11-30 /pmc/articles/PMC2803910/ /pubmed/20062690 http://dx.doi.org/10.1186/1757-1626-2-9113 Text en Copyright ©2009 Kyriazi et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Kyriazi, Maria A
Sofoudis, Chrisostomos
Katsouri, Maria
Kappos, Theocharis
Zafeiris, Christos
Trihia, Eleni
Diamantopoulos, Pantelis
Nomikos, Iakovos N
Acute cholangitis due to pancreatic metastasis from squamous cell lung carcinoma: a case report and review of literature
title Acute cholangitis due to pancreatic metastasis from squamous cell lung carcinoma: a case report and review of literature
title_full Acute cholangitis due to pancreatic metastasis from squamous cell lung carcinoma: a case report and review of literature
title_fullStr Acute cholangitis due to pancreatic metastasis from squamous cell lung carcinoma: a case report and review of literature
title_full_unstemmed Acute cholangitis due to pancreatic metastasis from squamous cell lung carcinoma: a case report and review of literature
title_short Acute cholangitis due to pancreatic metastasis from squamous cell lung carcinoma: a case report and review of literature
title_sort acute cholangitis due to pancreatic metastasis from squamous cell lung carcinoma: a case report and review of literature
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2803910/
https://www.ncbi.nlm.nih.gov/pubmed/20062690
http://dx.doi.org/10.1186/1757-1626-2-9113
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