부산대학교 도서관

Eighteen years ago, the patient underwent pancreaticoduodenectomy and portal vein resection for pancreatic head cancer. Pathological examination revealed a well-differentiated tubular adenocarcinoma, pStage IIB (T3N1M0). After the surgery, the patient received 6 months of gemcitabine (GEM) as adjuvant therapy and was subsequently placed under observation. Four years after the surgery, a solitary pulmonary nodule was detected in the left lower lobe and was diagnosed as lung metastasis from pancreatic cancer. Furthermore, the patient underwent 2nd partial lung resection in the right lower lobe which was followed by 3rd partial lung resection in the left upper lobe for metastases with 2 years interval, respectively. With the latest 10 years of recurrence-free, the patient has achieved a total of 14 years survival since the first lung resection. Although the systemic chemotherapy is the standard treatment for distant metastasis after pancreatic cancer surgery, it has been reported that the prognosis is better for cases with only lung metastasis compared to cases with metastasis in other organs. Therefore, lung resection may be considered in clinical practice. This case is a rare example of three solitary lung metastases recurrences that were managed only with surgical resections and achieved a good long-term outcome.