• Koki Hayashi, Minoru Kitago, Yuta Abe, Hiroshi Yagi, Yasushi Hasegawa, Shutaro Hori, Masayuki Tanaka, Yutaka Nakano, Keisuke Asakura, Yohei Masugi, and Yuko Kitagawa.
• Department of Surgery, Keio University School of Medicine, Shinjuku, Japan.
• Medicine (Baltimore). 2023 Nov 17; 102 (46): e35856e35856.

IntroductionPancreatic cancer (PC) is highly malignant and metastatic; however, bone metastases are rare. Although the effectiveness of conversion surgery for distant metastases of PC has been reported in a few cases, there are no reports on surgical resection for bone metastases. Here, we report a case of long-term survival after resection of bone metastasis from PC.Patient ConcernsA 60-year-old woman underwent pancreaticoduodenectomy after neoadjuvant chemoradiotherapy for pancreatic head cancer. At 28 months after surgery, multiple lung metastases from PC were diagnosed, and chemotherapy was administered. After 59 months, chemotherapy was terminated because all target lesions had disappeared on imaging.DiagnosisAt 77 months after the initial surgery, bone metastasis in the left 9th rib was detected by positron emission tomography/computed tomography, which was performed due to elevated carbohydrate antigen 19-9 levels.InterventionsChemotherapy was readministered as the initial treatment. Subsequently, due to the long-term well-controlled status of the recurrence site and the absence of other metastases, thoracoscopic-assisted partial resection of the left 9th rib was performed 128 months following pancreaticoduodenectomy. Pathological examination revealed adenocarcinoma metastasis from PC.OutcomesThe patient is currently alive without recurrence 44 months after resection for bone metastasis and 172 months after the initial surgery.ConclusionSurgical resection may be favorable in patients with bone metastasis of PC that is well-controlled with chemotherapy.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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