Surgical treatment for pancreatic metastasis from soft-tissue sarcoma - Report of two cases

We present two cases in which a soft-tissue sarcoma metastasized to the pan creas, but both patients survived as a result of repetitive surgical treatm ent during a 6- to 10-year period. The first case was a 29-year-old man who had a history of removal of mesenchymal chondrosarcoma in the left thigh i n 1986 and who underwent distal pancreatectomy and the enucleation of a tum or in the head of the pancreas because of the development of three metastat ic lesions in 1989. Afterward, although metastases were found in other orga ns, they were resected each time (for a total of five times) and the patien t has survived over 10 years. The second case was a 40-year-old woman who h ad a history of the removal of synovial sarcoma in the right thigh and had 6 surgical resections of local or pulmonary recurrent tumors. She underwent pylorus-preserving pancreaticoduodenectomy in 1993 because of the developm ent of a solitary metastatic lesion in the pancreas and survived more than 6 years after the pancreatectomy. Our report suggests, in selected cases, t hat long-term survival from pancreatic metastasis of soft-tissue sarcoma is expected as a result of curative resection. However, because pancreatic me tastasis has a potential to recur in other organs, it is necessary to take aggressive surgical procedures repeatedly for the treatment of recurrences to improve prognosis after pancreatectomy.