Metastatic disease to the pancreas: an imaging challenge

Triantopoulou, Charikleia; Kolliakou, E.; Karoumpalis, Ioannis; Yarmenitis, Spyros; Dervenis, Christos

doi:10.1007/s13244-011-0144-x

Cited by 46 publications

(40 citation statements)

References 40 publications

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“…This finding is critical as tumor metastatic to the pancreas could potentially be a poor prognostic indicator. Pancreatic metastases are quite rare, accounting for only 2% of all pancreatic cancers [8,9]. Most common primary tumors that metastasize to the pancreas are lung cancer, renal cell carcinoma, breast cancer, and melanoma [9].…”

Section: Discussionmentioning

confidence: 99%

Metastasis of Ewing Sarcoma to the Pancreas: Case Report and Literature Review

Polimera

Moku

Abusharar

et al. 2020

Case Reports in Oncological Medicine

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Ewing sarcoma (ES) is a highly aggressive malignant bone cancer. ES is part of the Ewing sarcoma family of tumors (ESFT), which express characteristic t(11;22) translocation as well as higher levels of CD99. Given that metastasis and tumor burden are significant prognostic factors in patient’s response to treatment, prompt diagnosis is needed to effectively treat ESFT patients. However, the challenges in classifying and characterizing ESFT complicate effective management and treatment of ES. In this report, we present a rare case of ES metastasis to the pancreas. Upon review of the literature, we found 39 cases of ESFT involving the pancreas, but only 3 were metastatic to the pancreas while the remaining cases of ESFT primarily originated from the pancreas. Given the rarity of such metastasis, the positive outcome in our patient’s case may explain the importance of prompt diagnosis in order to initiate appropriate treatment.

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Section: Discussionmentioning

confidence: 99%

Metastasis of Ewing Sarcoma to the Pancreas: Case Report and Literature Review

Polimera

Moku

Abusharar

et al. 2020

Case Reports in Oncological Medicine

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“…La symptomatologie des métastases pancréatiques est peu spécifiques, Elles peuvent se manifester par une altération de l'état général, des douleurs abdominales, ictère , pancréatite aiguë, insuffisance pancréatique, hémorragie digestive suite à l'envahissement pariétal du duodénum ; ou elles sont découvertes de façon fortuite dans le cadre du bilan de surveillance du cancer primitif . (4.5) L'intervalle de temps entre le cancer primitif et la détection de métastase varie considérablement, il survient généralement dans les 3 ans (6) ; Dans notre observation, l'intervalle entre le carcinome mammaire primitif et la métastase pancréatique était de 4 ans.…”

Section: Discussion:-unclassified

“…Al'échographie les métastases apparaissent sous forme de masses hypoéchogènes solides situées dans le parenchyme pancréatique (7) .L'injection d'un produit de contraste permet une exploration de la vascularisation, Les résultats de cette technique sont meilleurs dans les métastases de tumeurs hypervasculaires telles que le cancer des cellules rénales, les tumeurs neuroendocrines. (6) Le scanner abdominale révèle des lésions iso denses ou le plus souvent légèrement hypodenses (7) . Après injection de produit de contraste un rehaussementpériphérique est le plus souvent noté dans les lésions de plus de 1,5 cm, tandis que les lésions plus petites présentent un rehaussement homogène.…”

Section: Discussion:-unclassified

Case Report Late Solitary Pancreatic Metastasis From Breast Cancer

Idrissi¹,

Bakkari²,

Jerguigue³

et al. 2020

IJAR

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Pancreatic metastases from another primary malignant tumors are rare. In this article, we present the case of breast cancer, which metastasizes to the pancreas. The patient has diagnosed as breast cancer four years ago.Copy Right, IJAR, 2020,. All rights reserved. …………………………………………………………………………………………………….... Introduction:-Les localisations secondaires du cancer du sein sont le plus souvent de siège osseux , hépatique et pulmonaire (1) ; Les métastases pancréatiques sont rares , et représentent 2 à 4% de l'ensemble des tumeurs pancréatiques . nous rapportons une observation, d'une métastase pancréatique tardive d'uncarcinome lobulaire infiltrant du sein révélée par ictère cholestatique.Case report:-Patiente âgée de 39 ans , Bénéficiait, en avril 2014 d'une mastectomie avec curage ganglionnaire suivies d'une radiochiomiotherapie adjuvantes pour carcinome lobulaire infiltrant du sein gauche ; le bilan initial comportait un scanner thoraco-abdomino-pelvien et une scintigraphie osseuse ne montrant pas de localisation secondaire .Le suivi radiologique comportait une radiographie pulmonaire et échographie abdominale tous les six mois pendant trois ans, puis une fois par an. Ces examens restaient normaux.En janvier 2018 , la patiente consulte pour douleur épigastrique avec sub ictère , le bilan biologique trouve un ictère cholestatique ; elle a bénéficié d'une échographie première ;ayant montré une dilatation des voies biliaires intra hépatiques et de la voie biliaire principale sans obstacle visible , un complément IRM est ensuite réalisé comportant des séquencés T 1 avec saturation de graisse ; sans et avec injection de chélates de gadolinium , des séquences pondérées T2 ,diffusion ,et séquences BILI IRM ; ils ont objectivé une masse de la tête pancréatique en iso signal T1 et T2 (fig1 ) , en hypersignal diffusion ( fig 3) rehaussée après injection de produit de contraste (fig4) responsable d'une dilatation de la VBP et des VBIH (fig2). une biopsie scanno-guidée est ensuite réalisée , et l'examen anatomopathologique était en faveur d'une métastase de carcinome mammaire .

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“…In general, over 50 % of patients with pancreatic metastases are discovered incidentally during imaging studies, only the minority of patients with pancreatic metastases present with symptoms of malignant biliary obstruction (jaundice, abdominal pain, and weight loss) making this a challenging clinical scenario [14, 15]. …”

Section: Discussionmentioning

confidence: 99%

“…When evaluating solid pancreatic lesions, computed tomography (CT), magnetic resonance imaging (MRI), and EUS are very sensitive diagnostic methods, however, EUS allows for sampling, making this the preferred method to secure a diagnosis [14]. …”

Section: Discussionmentioning

confidence: 99%

Pancreatic metastases from ocular malignant melanoma: the use of endoscopic ultrasound-guided fine-needle aspiration to establish a definitive cytologic diagnosis: a case report

et al. 2016

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BackgroundWhen encountering solid pancreatic lesions, nonpancreatic primary metastases are rare and differentiating a metastasis from a primary neoplastic lesion is challenging. The clinical presentation and radiologic features can be similar and the possibility of a pancreatic metastasis should be considered when the patient refers to a history of a different primary cancer. Endoscopic ultrasound offers a key anatomical advantage in accessing the pancreas and endoscopic ultrasound-guided fine-needle aspiration has become the gold standard method for diagnosing pancreatic lesions.Case presentationA 58-year-old white Hispanic woman with a history of uveal malignant melanoma, presented with abdominal pain and jaundice. On admission, laboratory tests were performed (her total bilirubin was 6.37 mg/dL with a direct fraction of 5.30 mg/dL). Cross-sectional, abdominal computed tomography with contrast, showed a low-attenuating lesion localized in the pancreatic head (measuring 4 × 3 cm) and a thinner section of the distal bile duct suspicious for compression. Our patient was scheduled for an endoscopic ultrasound-guided fine-needle aspiration to establish a diagnosis. Endoscopic ultrasound showed a solid, hypoechoic, well-defined lesion with regular contours (measuring 3.17 × 2.61 cm), localized between the head and neck of the pancreas. Endoscopic ultrasound-guided fine-needle aspiration was performed with a 22G needle and cytology confirmed the diagnosis of metastatic melanoma. Our patient subsequently underwent right orbital exenteration, followed by duodenopancreatectomy without complications. At the moment our patient is receiving adjuvant chemotherapy at an outside oncology clinic.ConclusionsTo the best of our knowledge, this is a very rare presentation of an ocular malignant melanoma with an isolated pancreatic metastasis causing symptomatic biliary obstruction. Endoscopic ultrasound-guided fine-needle aspiration has proven to be the best method to diagnose solid pancreatic lesions. In this particular case, cytology was essential in confirming the diagnosis and guiding the most adequate therapy, which was a pancreatic resection, ocular exenteration of the melanoma, followed by adjuvant chemotherapy.

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Metastatic disease to the pancreas: an imaging challenge

Cited by 46 publications

References 40 publications

Metastasis of Ewing Sarcoma to the Pancreas: Case Report and Literature Review

Metastasis of Ewing Sarcoma to the Pancreas: Case Report and Literature Review

Case Report Late Solitary Pancreatic Metastasis From Breast Cancer

Pancreatic metastases from ocular malignant melanoma: the use of endoscopic ultrasound-guided fine-needle aspiration to establish a definitive cytologic diagnosis: a case report

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