Pancreatic IPMN Cancer: A Rare Case of Bone Metastases

Bouddabous S and Farracho L

Department of Imaging and Medical Information Sciences, Geneva University Hospital, Switzerland

^*Correspondance to: Bouddabous S 

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Abstract:

We report a case of a 70-year-old male with1-month history of 9 kg weight loss and abdominal pain. Physical examination was normal and hepatic tests revealed a cholestasis. CT scan showed a pancreatic head mass associated with biliary ducts dilatation and an echo-endoscopic-guided fine needle aspiration of this lesion suggested an intraductal papillary mucinous neoplasm (IPMN) with mild dysplasia.A duodenopancreatectomy of the head of the pancreas was performed and histological images have shown a mixed adenocarcinoma with endocrine differentiation developed over an IPMN with one ganglion metastasis and negative resection margins. Subsequently, the patient received a treatment with 6 cycles of gemcitabine.A pulmonary metastasis appeared after one year of follow up and it was resected with success.Three years after the 4th lumbar vertebrae presented a lytic pattern and was treated with cementoplasty, but lumbar pain got worse. Lumbar vertebrae magnetic resonance imaging (MRI) showed a multi-lobulated lesion with peripheral enhancement in this vertebrae and a pseudocollection along the subcutaneous and bone path of the cementoplasty’s needle. A percutaneous biopsy was performed and revealed a metastatic disease. The patient presented later multiple bone cystic lesions in the pelvis and spine.This case illustrates a rare feature of IPMN bone metastases, rarely described on literature. This diagnosis should be considered when a history of cystic pancreatic tumour is known and an invasive procedure like biopsy is required to confirm the diagnosis.

Keywords:

Pancreatic cancer-IPMN-cystic; Bone metastases

Cite the Article:

Bouddabous S, Farracho L. Pancreatic IPMN Cancer: A Rare Case of Bone Metastases. Ann Clin Case Rep. 2016; 1: 1131.