Metastatic Pancreatic Cancer in 19-Year-Old: 3011

INTRODUCTION: Pancreatic cancer is a highly aggressive cancer. Worldwide, pancreatic cancer is the eighth leading cause of cancer deaths in both men (226,910 deaths annually) and women (205,332 deaths annually). Five-year survival rate even for node negative R0 pancreaticoduodenoectomy is only 30 percent and it is worse in case of node positive cancer at 10%. 1 Here we present an extremely rare case of advanced metastatic cancer with metastasis to central nervous system at the age of 18 with no familial history. CASE DESCRIPTION/METHODS: 19-year-old obese male presented as a transfer from outside hospital for increasing weakness and worsening confusion. His past medical history is significant for metastatic pancreatic cancer and smoking. On physical he was found to be lethargic, disoriented unable to answer questions with more than one word. Labs were CA 19-9 of 5423 and CEA of 244. MRI showed leptomeningeal enhancement and 3.8 cms mass at pancreatic head. Lumbar puncture was performed and CSF analysis showed the presence of malignant cells. He was now referred to hospice as he was no longer a treatment candidate. DISCUSSION: SEER (surveillance, epidemiology and end results program) database the incidence of pancreatic cancer in the age group our patient was in was 0.1% per 100,000 cases. 2 In the NCRAS (National cancer registration and analysis service) database from 1998 to 2006 there were only 6 registered cases of pancreatic cancer. 4 Early onset pancreatic cancer patients usually have an aggressive presentation and survivals are shorter with same tumor size.