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Cystic metastasis from an adenocarcinoma of pancreas: A case report.

Introduction
A 75-year-old female was presented to our hospital due to obstructive jaundice. Computed tomography demonstrated a pancreatic head mass that causing common bile duct and intrahepatic duct dilatation without evidence of advanced disease. She was underwent pyloric-preserving pancreatoduodenectomy and they discharge without complication. Although the incidence of hepatic cystic liver metastasis from pancreatic cancer is extremely rare, care should be taken to when a cystic liver lesion was detected with pancreatic cancer.


Methods
In operative finding, we found the 1-cm liver cyst at segment 5 and excisional biopsy was done. The pathological report revealed well-differentiated adenocarcinoma of head of pancreas without nodal metastasis and cystic metastasis well-differentiated adenocarcinoma of liver.


Results
Then we reviewed the imaging study, it showed a small cystic lesion without enhancing portion at liver segment 5 that mimics intrahepatic duct dilatation and a cystic lesion at segment 6 that previously seen in preoperative imaging study. The patient underwent chemotherapy with Gemcitabine. Six months after surgery, the computed tomography revealed increase sized of cystic lesion at segment 6 and development of ascites. Ten months after surgery, the patient was dead due to severe septicemia from urinary tract infection. The previous study show a range of spectrum of hepatic cystic liver metastasis with histopathologic confirmation of diagnosis.


Conclusions
Although the incidence of hepatic cystic liver metastasis from pancreatic cancer is extremely rare, care should be taken to when a cystic liver lesion was detected with pancreatic cancer.