Introduction : Best treatment option for pancreatic cancer is surgery depending upon the stage of the cancer. Some times we have to downstage the tumor before resection. Extra pancreatic spread must be ruled out. In our case, we came across adenocarcinoma pancreas which was metastasized to the liver but later on after down staging no metastasis was found in the liver and tumor resection of pancreas was done.It was very much new for us as we have hardly seen any case where carcinoma head of pancreas with liver metastasis was downstage and then operated.

Methods : A 50 years old male patient was initially diagnosed with cancer head of pancreas. It was already involved the liver at the time of diagnosis. Three nodules in the liver had characteristic features of metastasis. Oncologist downstaged the tumor and later on he became free from the tumor both in the liver and pancreas. After 6 months he developed features of obstructed jaundice. MRCP confirmed the presence of tumor head of pancreas. There was no liver metastasis. ERCP stenting was done. Biopsy confirmed the pancreas tumor. Surgery was done and specimen was found with tumor free margin.

Results : Patient was discharged with out any complication. He is in the regular follow up for last 6 months.

Conclusions : Adenocarcinoma pancreas is very much aggressive tumor and most of the time it is found to be beyond the resection. This is the one case but need more cases to make a final decision.