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Case Report
Lung adenocarcinoma mimicking metastatic pancreatic cancer, a diagnostic dilemma
1 Physician, Florida Cancer Specialists and Research Institute, Fort Myers, Florida, United States
Address correspondence to:
Raymond M Esper
8260 Gladiolus Drive, Fort Myers, Florida 33908,
United States
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Article ID: 100061Z10RE2019
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Esper RM. Lung adenocarcinoma mimicking metastatic pancreatic cancer, a diagnostic dilemma. J Case Rep Images Oncology 2019;5:100061Z10RE2019.ABSTRACT
Aim: Solid tumors rarely metastasize to the pancreas, but multifocal pancreatic cancer is practically unheard-of. Modern genetic and molecular tumor profiling can more accurately determine a tissue of origin than standard immunohistochemistry techniques. When dealing with widely metastatic disease with multiple pancreatic masses, it is imperative to have an accurate diagnosis of primary pancreatic cancer versus metastasis from another site to the pancreas, as that would significantly alter treatment options and overall outcomes.
Case Report: Here, I present a case of molecularly confirmed lung adenocarcinoma with widespread metastasis including the pancreas, liver, and lymph nodes leading to an initial clinical misdiagnosis and improper treatment recommendations. Fortunately, the correct diagnosis was made in a timely manner and molecular profiling of the tumor determined the appropriate treatment strategy leading to near-complete remission.
Conclusion: Modern molecular assays are now a critical part of our diagnostic armamentarium and besides identifying targetable mutations, can help to determine the site of origin in cases of poorly differentiated metastatic disease.
Keywords: Immunotherapy, Lung cancer, Metastasis to pancreas, Molecular profiling
SUPPORTING INFORMATION
Acknowledgments
The author would like to thank the staff of Florida Cancer Specialists in helping to expedite this patient’s care.
Author ContributionsRaymond M Esper - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthor declares no conflict of interest.
Copyright© 2019 Raymond M Esper. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
