Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Jul 16, 2022; 14(7): 455-466
Published online Jul 16, 2022. doi: 10.4253/wjge.v14.i7.455
Solitary pancreatic metastasis from squamous cell lung carcinoma: A case report and review of literature
Kaouthar Rais, Oumayma El Eulj, Najoua El Moutaoukil, Imane Kamaoui, Amal Bennani, Ghizlane Kharrasse, Abdelkrim Zazour, Wafaa Khannoussi, Zahi Ismaili
Kaouthar Rais, Oumayma El Eulj, Najoua El Moutaoukil, Ghizlane Kharrasse, Abdelkrim Zazour, Wafaa Khannoussi, Zahi Ismaili, Department of Hepatogastroenterology, Mohammed VI University Hospital Center, Digestive Disease Research Laboratory, Medical School, Mohammed I University, Oujda 60000, Morocco
Imane Kamaoui, Department of Radiology, Mohammed VI University Hospital Center, Digestive Disease Research Laboratory, Medical School, Mohammed I University, Oujda 60000, Morocco
Amal Bennani, Department of Anatomo-Pathology, Mohammed VI University Hospital Center, Digestive Disease Research Laboratory, Medical School, Mohammed I University, Oujda 60000, Morocco
Author contributions: Rais K and El Eulj O reviewed the literature and contributed to writing of the manuscript; El Moutaoukil N collected the patient’s clinical data; Zazour A, Khannoussi W and Ismaili MZ contributed in performing endoscopic retrograde cholangiopancreatography and endoscopic ultrasound + fine-needle aspiration and correcting the manuscript for important intellectual content; Kharrasse G participated in the multidisciplinary consultation meetings and in confirmation of the patient’s diagnosis; Kamaoui I interpreted the imaging findings; Bennani A analyzed the biopsies of the pancreatic mass; all authors read and approved the manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors declare they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kaouthar Rais, MD, Doctor, Department of Hepatogastroenterology, Mohammed VI University Hospital Center, Digestive Disease Research Laboratory, Medical School, Mohammed I University, BP 4806 Oujda University 60049, Oujda 60000, Morocco. kaoutar.rais@gmail.com
Received: April 6, 2022
Peer-review started: April 6, 2022
First decision: April 28, 2022
Revised: May 18, 2022
Accepted: June 15, 2022
Article in press: June 15, 2022
Published online: July 16, 2022
Abstract
BACKGROUND

Pancreatic metastases from squamous cell lung carcinoma (SCLC) are unusual. These lesions are often asymptomatic and detected incidentally or during follow-up investigations, occasionally several years after removal of the primary tumor.

CASE SUMMARY

A 56-year-old male with SCLC developed jaundice 1 mo after the cancer diagnosis. An abdominal computed tomography (CT) scan showed a mass in the pancreatic head with distention of both intra- and extrahepatic biliary ducts. Endoscopic retrograde cholangiopancreatography and sphincterotomy were performed first, culminating with plastic biliary stent placement. Cytological examination of the pancreatic mass sample collected by fine-needle aspiration (FNA) under endoscopic ultrasound (EUS) guidance revealed the presence of malignant cells compatible with well-differentiated squamous cell carcinoma. After liver function normalized, chemotherapy was initiated with carboplatin and paclitaxel; however, 4 d later, the patient presented dysphagia. Cervico-thoraco-abdominal CT showed tracheoesophageal fistula and stent migration. After replacement with a 10 cm/10 mm uncovered metallic biliary stent and treatment of the tracheoesophageal fistula with a fully covered esophageal stent, the patient was able to start oral feeding progressively. He died 9 mo after the initial diagnosis.

CONCLUSION

The diagnosis of pancreatic metastasis from SCLC is challenging for clinicians. EUS-FNA is the primary exam for confirmatory diagnosis.

Keywords: Squamous cell lung carcinoma, Pancreatic metastasis, Jaundice, Esotracheal fistula, Ultrasound endoscopy, Case report

Core Tip: The pancreatic metastasis of squamous lung carcinoma is a rare disease. There are a few cases in the literature that discuss the modality of diagnosis and the treatment of pancreatic metastasis. In this manuscript, we report our experience in the management of this case and the malignant tracheoesophageal fistula as a rare complication of squamous lung carcinoma.