Background : Introduction: Hepatocellular carcinoma (HCC) is a highly malignant, generally fatal neoplasm arising from hepatocytes. Extrahepatic metastases are not rare at diagnosis of HCC, and the most frequent sites of extrahepatic metastases are lung, abdominal lymph node and bone. In contrast, metastatic pancreatic cancer (MPC) from HCC is extremely rare.

Methods : Case report: We here present a case of pancreatic metastasis from HCC in a 76-years old patient. The patient had a history of hypertension and diabetes mellitus. On regular check-up, Alpha-fetoprotein (AFP) was measured as 1500 ng/ml, and multiple HCC were confirmed by radiographic images. Trans catheter arterial chemoembolization was performed for HCC lesions and Sorafenib was administrated. After 4 months of follow-up, an infiltrative lesion of 6 centimeters in the tail of pancreas was observed on computer tomography images. The patient received distal pancreatectomy. On immunohistochemical staining, hepatocyte and AFP were strongly expressed, which was confirmed as MPC from HCC. The patient is currently alive 29 months after surgery.

Results : Discussion: The MPC is a rare disease which accounts for 2% of all pancreatic malignancies. The MPC most commonly occurs in the tail of the pancreas. The most common site of primary cancer for MPC is kidney, followed by breast and lung. Several studies reported better survival outcomes of radical resection in MPC patients from renal cell carcinoma. Although there have been only a few case reports for MPC from HCC, the patients in this case report had a good survival outcome after radical resection.

Conclusions : Conclusion: The possibility of pancreatic metastasis from other primary cancer, and surgical approach for eligible patients should be considered.