Title : Metastatic pancreatic adenocarcinoma mimicking primary colonic malignancy: A rare case involving the colon, spleen, and kidney
Abstract:
Pancreatic ductal adenocarcinoma (PDAC) remains one of the most lethal malignancies, characterized by aggressive behavior and a high propensity for metastasis, typically to the liver, peritoneum, and lungs. Metastatic involvement of the colon, however, is exceptionally uncommon and often leads to diagnostic confusion. We report the case of a 64-year-old male who presented with nonspecific gastrointestinal and genitourinary symptoms. Initial imaging and endoscopic biopsy suggested a primary colonic malignancy. However, histopathological evaluation and immunohistochemical profiling confirmed metastatic pancreatic adenocarcinoma. The patient underwent en bloc resection, including left hemicolectomy, distal pancreatectomy, partial nephrectomy, and splenectomy. This case underscores the importance of considering pancreatic cancer in the differential diagnosis of atypical gastrointestinal masses and highlights the role of immunohistochemistry in clarifying the tumor origin in ambiguous presentations.
Keywords: Pancreatic adenocarcinoma, colonic metastasis, immunohistochemistry, diagnostic challenge, CK7, CK20, CDX2.
