Splenomegaly as the first manifestation of pancreatic adenosquamous carcinoma: a case report.

Cevre dokular› invaze eden pankreas›n adenoskuamoz karsinomu nadir gorulur. Burada, 44 yafl›ndaki erkek hastada dalak ve ko- lonu invaze eden pankreas kokenli pankreas›n adenoskuamoz karsinomu vakas› sunulmufltur. Goruntuleme yontemleri ile buyu- mufl dalakta dev heterojen kitle ve kolonda kitle tespit edilmifl ancak pankreasta yer kaplayan lezyon gorulmemifltir. Tan›sal lapa- ratomide dala¤›n, pankreas kuyruunun ve kolonun birbirine yap›flt›¤› tespit edilmifltir. Splenektomi ile beraber, pankreas›n kuy- ruu ve kolonun splenik fleksura bolgesi de eksize edilmifltir. Distal pankreatektomi orneinde 0.8 cm boyunda solid kitle tespit edil- mifltir. Tumorun adenokarsinoma ve skuamoz karsinoma ozelliklerini bir arada tafl›¤› gorulmufltur. Baflvurudan 5 ay sonra hasta kafleksiden ex olmufltur. Bu vaka dala¤› tutan metastatik tumorun orjinindekinden daha buyuk olmas› nedeni ile ozeldir. Anahtar kelimeler: Pankreas›n adenoskuamoz karsinomu, dalak invazyonu, kolon invazyonu Adenosquamous carcinoma of the pancreas directly invading surrounding organs is rare. Here, we describe a case of pancreatic ade- nosquamous carcinoma directly invading the spleen and colon in a 44-year-old man. Imaging examinations revealed a huge hete- rogeneous mass in the enlarged spleen and a colonic lump, but showed no obvious space-occupying lesion in the pancreas. An exp- loratory laparotomy revealed that the enlarged spleen, pancreatic tail, and splenic flexure of the colon were firmly attached to one another. Splenectomy combined with resection of the distal pancreas and splenic flexure of the colon was performed. In the distal pancreatectomy specimen, a 0.8-cm solid mass was present in the tail. The tumor contained definite components of both adenocar- cinoma and squamous cell carcinoma. The patient died of cachexia five months after admission. This case is unique in that the me- tastatic tumor involving the spleen was considerably larger than the primary tumor itself.