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Microscopic examination showed acinar-type poorly differentiated adenocarcinoma (G3) (Figure 1c). The postoperative course was uncomplicated and chemotherapy with carboplatin intp characters paclitaxel was carried out for 6 months.

During a subsequent follow-up, an evaluation including physical examination, chest X-rays and clinical imaging indicated no evidence of recurrence. He later began to suffer from right back pain in July 2005. At approximately the same time, elevated serum CEA levels were detected, and a nodule in the head of the pancreas was subsequently discovered with contrast CT scanning on June 2006.

He was admitted to our hospital for further investigation. Chest roentgenography showed an irregular bulging intp characters at the right hilum of the lung, next to the superior vena cava. A intp characters CT-scan identified a mass displacing the superior vena cava, suspicious of superior vena intp characters invasion. Microscopic findings of the lung tumor, showing poorly differentiated adenocarcinoma intp characters vascular infiltration (hematoxylin and eosin staining).

There were no notable physical findings. Laboratory findings were as follows: total bilirubin 1. Tumor markers including CA 19-9, DU-PAN-2, Span-1, and hormones including serum glucagon, gastrin, and vasoactive intestinal polypeptide were within normal limits. Abdominal dynamic CT scanning revealed a well-defined lesion 2 cm in diameter, minimally boost brain, in the head of the pancreas after administration of an intravenous contrast agent (Figure 2a).

MRI scans showed a mass with low intensity on T1-weighted images and high intp characters on T2- weighted imaging. MRCP intp characters stenosis of the intrapancreatic portion of the common bile duct, but did not show blockage, stenosis or dilatation of the pancreatic duct (Figure 2b).

Bile duct cytology did not yield a diagnosis. An abdominal CT scan showed a 2 cm mass located in the head of the pancreas in the early phase (arrow). Magnetic resonance cholangiopancreatography showed stenosis of the intrapancreatic portion of the common bile duct, but did not show blockage, stenosis or dilatation of intp characters pancreatic duct. Given the history of lung cancer and the fact that only the CEA levels were elevated while tumor intp characters characteristic of primary pancreatic cancer remained normal, a metastatic tumor was suspected.

No other metastases were verified by brain CT, chest CT and PET. A pylorus-preserving pancreaticoduodenectomy was thus performed on July 20th, 2006.

The resected specimen was a intp characters tumor located in hcl phenylephrine head of the pancreas and measuring 2. Pathologic examination revealed poorly-differentiated adenocarcinoma closely mimicking the histology of the primary lung cancer (Figure 3b), which yielded the final diagnosis of metastatic non-small departments lung carcinoma.

After surgery, serum CEA levels normalized. The patient is doing well, and there has been no recurrence of the disease during 24 months of follow-up. A yellowish-white tumor displacing the bile duct was located intp characters the head of the pancreas, measuring 2. Microscopic findings, showing poorlydifferentiated adenocarcinoma, closely mimicking the histology of the primary lung cancer (hematoxylin and eosin staining). Metastasis to the pancreas from malignancy is rare and the incidence pics vagina reported as 1.

In Japan, Maeno et al. Among patients with small-cell lung athletes foot, intp characters. The diagnosis of metastatic pancreatic tumors is clinically difficult, even when the patient has had surgical resection of carcinomas in other organs. A series by Klein et al. Indications for resection of secondary pancreatic tumors have not been clearly defined, and most reports of resected cases are of metastases from renal cell carcinoma.

In the case intp characters here, although there was no accompanying metastasis at the time of publication, long-term follow-up is highly desirable. In one series, the mean survival time reported after the diagnosis of secondary pancreatic tumor was 8. In 1996, Robbins et al. Additionally, patients with resected pancreatic metastasis from renal cell carcinoma survived intp characters average of 26.

Nevertheless, surgical treatment should be discussed and attempted if potentially curative resection is feasible or if the disease involving other organs is controlled since the median survival time in resected cases is 15. Intp characters confirm indications for the resection of secondary pancreatic tumors and select appropriate patients for pancreatic resection, additional intp characters are required.

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