An Uncommon Cause of Hematochezia

Excerpt

A diagnosis of pancreatic cancer carries a very poor prognosis and is the fourth leading cause of cancer-related mortality in developed nations [1]. In the USA, pancreatic cancer accounts for almost 3% of all the cancers and almost 7% of all cancer deaths [2]. The poor prognosis associated with pancreatic cancer is directly related to the timing of diagnosis which frequently occurs when the cancer is already in an advanced stage with approximately 50% of the patients having metastasis at the time of diagnosis and only 20% having resectable tumors [3]. Common sites for metastasis of pancreatic cancer include the liver, peritoneum, lungs, and lymph nodes. Rarely, pancreatic cancer metastasizes to the colon [1]. This case report highlights an occurrence of pancreatic adenocarcinoma with metastasis to the colon that presented clinically as hematochezia. An extensive literature search found only nine cases of colonic metastasis from primary pancreatic cancer. We did not include cases which involved direct extension of the pancreatic lesion into the colonic mass or cancers involving pancreatobiliary systems in our review. Our case is unique in a sense that it is the second reported case in literature which initially presented with hematochezia and was ultimately found to be pancreatic cancer with metastasis to the colon. …