<b>Metastatic cancer involving pancreatic duct epithelium and its mimicry of primary pancreatic cancer</b>

To investigate the clinicopathological features of patients with secondary tumors of the pancreas, we reviewed autopsy records and pathological features of 103 cases with pancreatic secondary tumors from 690 cases of malignant tumors (excluding cases of primary pancreatic cancer) over a 10-year period. There were 67 men and 36 women in the study, ranging in age from 2 to 94 years (mean: 61 years). The incidence of pancreatic secondary tumors was 15% in the autopsy cases of malignant tumors, and the majority of the secondary tumors were carcinomas. The stomach was the most common primary tumor site (20%), followed by the lung (18%) and extrahepatic bile duct (13%). Because the total number of each primary carcinoma differed, we paid specific attention to the incidence of pancreatic metastasis in each primary carcinoma. We found that carcinoma of the papilla of Vater showed the highest rate of incidence (75%) of pancreatic metastasis in each type of primary carcinoma. Approximately half of the metastatic lesions were solitary, but the metastatic lesions in the pancreas could not be identified macroscopically in 34 cases (33%). Histologically, the most common carcinoma was adenocarcinoma, followed by large cell carcinoma, small cell carcinoma and neuroendocrine carcinoma. The most common non-epithelial tumor was leukemia, followed by malignant lymphoma. Undifferentiated carcinoma and neuroendocrine carcinoma were often found in cases of extrahepatic bile duct or urinary bladder carcinoma with pancreatic metastasis. As for the microscopic infiltration patterns of tumor cells, 73% of cases showed an interlobular and intralobular infiltration. Fat necrosis was most frequently seen as an associated pathological finding (19%). Our study indicates that secondary tumors of the pancreas can be found in approximately one out of six to seven autopsy cases of malignant tumors, and in Japan, the most common of these is adenocarcinoma of the stomach.

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“…All of their three cases were primary lung adenocarcinomas. 12 However, we did not identify such cases in the present study.…”

Section: Discussioncontrasting

confidence: 59%

“…Matsukuma et al recently described a unique case of pancreatic metastasis: intraductal pagetoid spread of metastatic cancer cells. All of their three cases were primary lung adenocarcinomas 12 . However, we did not identify such cases in the present study.…”

Section: Discussionmentioning

confidence: 59%

Secondary tumors of the pancreas: Clinicopathological study of 103 autopsy cases of Japanese patients

Nakamura

Shimizu

Itoh

et al. 2001

Pathology International

155

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“…We also observed colonization of the ductal epithelium by metastatic tumor cells in some of our cases. Both intraductal growth and pagetoid spread to the ducts have been reported in the literature as well [53]. Fat necrosis and other signs of pancreatic injury may be seen [63].…”

Section: Discussionmentioning

confidence: 92%

“…While the majority of the tumors involving the pancreas are either of pancreatic, biliary, or periampullary origin, there are a variety of tumors involving this organ secondarily, which have different clinicopathological presentations and outcomes [10,11,20,26,32,39,45,46,53,63,66,67,75,77,96]. Most of the studies reported in the literature focus on the radiological and ultrasonographic characteristics of secondary tumors and their differential diagnosis from primary pancreatic carcinomas [10,11,20,26,39,66,67,77,96].…”

Section: Introductionmentioning

confidence: 99%

Secondary tumors of the pancreas: an analysis of a surgical and autopsy database and review of the literature

et al. 2004

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The vast majority of pancreatic carcinomas are primary, and, among these, more than 90% are of ductal origin. However, a variety of extrapancreatic tumors may involve the pancreas secondarily and may manifest different clinicopathological characteristics and outcomes. In this study, pathology material from 973 surgical specimens and 4955 adult autopsy cases was reviewed to identify the tumors metastatic to or secondarily involving the pancreas. Biliary and periampullary neoplasms and tumors confined to peripancreatic soft tissue were excluded. In the autopsy series, the pancreas was involved by tumor in 190 cases, and 81 of these were secondary tumors. These were predominantly of epithelial origin, most commonly from lung (34), followed by GI tract (20), kidney (4), breast (3), liver (2), ovary (1), and urinary bladder (1). In addition, there were six tumors of hematopoietic origin, two melanomas, two sarcomas, and two mesotheliomas. Among the 973 surgical specimens, 38 cases contained metastatic tumors to the pancreas. Of these, 11 were lymphomas, and the others were carcinomas of stomach (7), kidney (6), lung (2), liver, prostate, ovary, uterus (1 case of each), and a Merkel cell carcinoma. In addition, there were three malignant gastrointestinal stromal tumors and one retroperitoneal leiomyosarcoma. In conclusion, lung cancer is the most common source of metastasis to pancreas, followed by gastrointestinal carcinomas and lymphomas. These tumors are usually seen in patients with disseminated disease and are detected mainly in autopsies. Secondary tumors constitute about 4% of pancreatic specimens in the authors' surgical database. Approximately one-third of them are clinically mistaken as primary tumors of the pancreas. These are predominantly hematopoietic malignancies or carcinomas of renal or gastric origin. Secondary tumors should be entertained in both the clinical and pathological differential diagnosis of pancreatic neoplasia.

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“…The most common site can be lung carcinoma, renal cell carcinoma, colon carcinoma, or stomach carcinoma 9–13,15,16,18,19,21–27. Mesa et al reviewed all secondary tumours of pancreas in literature by Medline between 1966 and 2003 18.…”

Section: Frequency Of Pancreatic Metastasismentioning

confidence: 99%

Pancreatic involvement in small cell lung cancer

Gönlügür¹,

Mirici²,

Karaayvaz³

2014

Radiology and Oncology

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BackgroundFew data are available concerning incidence, clinical picture, and prognosis for pancreatic metastases of small cell lung carcinoma. In this paper we review the related literature available in English language.ConclusionsAlthough pancreatic metastases are generally asymptomatic, they can rarely produce clinical symptoms or functional abnormalities. The widespread use of multi-detector computerised tomography (CT) in contemporary medical practice has led to an increased detection of pancreatic metastases in oncology patients. Tissue diagnosis is imperative because radiological techniques alone are incapable of differentiating them from primary pancreatic tumours. Pancreatic metastases occur in the relative end stage of small cell lung cancer. The main complications of these lesions, although rare, are acute pancreatitis and obstructive jaundice. Early chemotherapy can provide a survival benefit even in patients with mild acute pancreatitis or extrahepatic biliary obstruction.

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Metastatic cancer involving pancreatic duct epithelium and its mimicry of primary pancreatic cancer

Cited by 14 publications

References 3 publications

Secondary tumors of the pancreas: Clinicopathological study of 103 autopsy cases of Japanese patients

Secondary tumors of the pancreas: Clinicopathological study of 103 autopsy cases of Japanese patients

Secondary tumors of the pancreas: an analysis of a surgical and autopsy database and review of the literature

Pancreatic involvement in small cell lung cancer

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