[Solitary metastasis to the pancreas in a patient with lung cancer].

We present the case of a 52-year-old man with a history of smoking (30 pack-years) and childhood tuberculosis who complained of left suprascapular mechanical pain of one month’s duration and increasing in spite of analgesic treatment. A chest x-ray showed an opacity in the upper left lobe with loss of volume and areas of emphysema. A computed tomography (CT) scan of the thorax and abdomen showed a mass in the upper left lobe 6×7 cm in size invading the chest wall and a hypodense lesion in the tail of the pancreas 1.3 cm long. Fiberoptic bronchoscopy revealed complete stenosis of the apicoposterior segment of the bronchus of the upper left lobe. Biopsies were positive for large-cell carcinoma. A bone scintigram was normal. We decided to perform a positron emission tomography (PET) scan, which revealed pathological uptake in the upper left lobe of the lung and another area of tracer accumulation in the tail of the pancreas. Mediastinoscopy ruled out mediastinal node involvement. Exeresis of the pancreatic nodule with body/tail pancreatectomy was performed. The pathologist diagnosed moderately differentiated carcinoma that was probably metastatic. No invasion of the peripancreatic lymph nodes or those of the hilus of the spleen was observed. A left radical pneumonectomy was then performed by left thoracotomy, with resection of the third, fourth, and fifth ribs. The resection margins were tumor-free and the patient’s course was favorable, without complications.