3D Printing for Preoperative Planning in Pancreatic Resection for Rare Metastasis from Ovarian Cancer: a case report

Abstract

Secondary pancreatic malignancies are a rarely reported entity, limited to sporadic case reports in the medical literature. Most often, these secondary malignancies are of renal origin, followed by gastrointestinal tumors and lung cancer as the primary tumor sites. Metastatic tumors from ovarian origin are few and far between. In our understanding this is the first time 3D printing has been used in the preoperative planning of one such case. Case presentation We present the case of a 63 year old patient with a history for bilateral ovariectomy for ovarian tumor 5 years prior, with a 3D printed model of the patient’s anatomy used for preoperative planning as a novel approach. During regular check-ups, an elevated CA19-9 level prompted a CT scan showing a distal pancreatic mass entering the splenic hilum, and a PET scan showed FDG avid lesion considered malignant and no other lesions were detected. The location of the metastasis warranted a distal pancreatectomy with splenectomy. To aid in the preoperative planning a 1:1 replica of the patient’s anatomy was constructed based on the CT scan, and it was manufactured using 3D printing. After extirpation of the tumor, the histological analysis showed a pancreatic pseudocyst with an intraluminal neoplastic proliferation, and further immunohistochemistry analysis determined the immunophenotype suitable of an ovarian cystadenocarcinoma metastasizing to the pancreas. Conclusions The surgical team was unanimous in the impression that the 3D printed model facilitated a swift surgery without any complications. Not only the model helped the planning phase, it is useful as a tool for patient education and further education of students and residents.</jats:p>