Metastatic neoplasms to the pancreas diagnosed by fine‐needle aspiration/biopsy cytology: A 15‐year retrospective analysis

Raymond, Sasha; Yugawa, Deanne; Chang, Karen; Ena, Brandy; Tauchi-Nishi, Pamela

doi:10.1002/dc.23752

Cited by 23 publications

(15 citation statements)

References 39 publications

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“…Regarding neoplasm location, pancreatic head/neck was the most common location for metastasis in this study and other studies [ 4 , 10 ]. RCC is the most common primary tumor in PMET reported in literature, although some studies have described that lung cancer is the most common one [ 4 , 7 , 8 , 11 - 13 ]. This might be due to the tendency for hematogenous spread in RCC [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Metastatic tumors to the pancreas: Balancing clinical impression with cytology findings

Abdallah

Bohy

Singal

et al. 2022

Ann Hepatobiliary Pancreat Surg

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Backgrounds/Aims Metastatic lesions of the pancreas (PMET) account for 1%–5% of all malignant solid pancreatic lesions (SPL). In this study we evaluated the utility of endoscopic ultrasonography with fine needle aspiration (EUS-FNA) in diagnosing PMET. Methods Patients who underwent EUS-FNA at a community referral center between 2011–2017 for SPL were identified. Clinical, radiologic, and EUS-FNA features of those with PMET were compared to those with primary solid tumors of the pancreas: pancreatic adenocarcinoma (PDAC) and neuroendocrine tumors (PNET). Results A total of 191 patients were diagnosed with solid pancreatic malignancy using EUS-FNA: 156 PDAC, 27 PNET, and eight (4.2%) had PMET. Patients with PMET were less likely to have abdominal pain (25.0% vs. 76.3% vs. 48.2%; p < 0.01) or obstructive jaundice (37.5% vs. 58.3% vs. 0%; p < 0.01) compared to PDAC and PNET. Those with PMET were more likely to have mass lesions with/without biliary or pancreatic ductal dilatations (100% vs. 86.5% vs. 85.2%; p < 0.01) and lower CA19-9 (82.5 ± 43.21 U/mL vs. 4,639.30 ± 11,489.68 U/mL vs. 10.50 ± 10.89 U/mL; p < 0.01) compared to PDAC and PNET. Endosonographic features were similar among all groups. Seven (87.5%) patients with PMET had a personal history of malignancy prior to PMET diagnosis. The primary malignancy was renal cell carcinoma in five PMET. Conclusions PMET are exceedingly rare, comprising less than 5% of SLP. Patients with PMET are less likely to present with symptoms and mostly identified by surveillance imaging for the primary malignancy.

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Section: Discussionmentioning

confidence: 99%

Metastatic tumors to the pancreas: Balancing clinical impression with cytology findings

Abdallah

Bohy

Singal

et al. 2022

Ann Hepatobiliary Pancreat Surg

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“…Out of 4955 adult autopsy cases in the same study, there were 190 cases of pancreatic tumors, none with MCC. Raymond et al 16 reported a single case of MCC among 221 patients who were diagnosed with a pancreatic malignancy via FNA/core needle biopsy. Primary pancreatic neoplasm is an important differential for MCC metastatic to pancreas, especially with isolated pancreatic involvement.…”

Section: Discussionmentioning

confidence: 99%

Merkel Cell Carcinoma With Isolated Pancreatic Metastasis

Lingamaneni

Laswi

Krbanjevic

et al. 2021

Journal of Investigative Medicine High Impact Case Reports

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Merkel cell carcinoma (MCC) is a highly aggressive cutaneous neuroendocrine carcinoma, frequently associated with distant metastasis. However, recurrence of MCC manifesting with only pancreatic involvement is exceedingly rare. A 53-year-old man presented to our institution with abdominal discomfort 3 months after initial resection of chest wall MCC. Imaging revealed lesions in the pancreas and peripancreatic lymph nodes. Pathology obtained through endoscopic ultrasound confirmed recurrence of MCC. He underwent chemotherapy with cisplatin and etoposide, resulting in a complete resolution of the pancreatic lesions. Unfortunately, he passed away from sudden cardiac arrest while being in remission from MCC. Immunohistochemistry is crucial in differentiating MCC from primary pancreatic glandular and neuroendocrine tumors. While there are no definitive guidelines in the management of pancreatic lesions associated with MCC, checkpoint inhibitor immunotherapy is increasingly being used.

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“…Pancreatic metastatic accounted for 0.9%-2.5% of EUS-FNA samples of the pancreas and 4.7%-7.2% of pancreatic malignancies[ 27 - 29 ]. These figures may be higher than those of other modalities because lesions with typical findings of pancreatic adenocarcinoma may be resected without EUS-FNA.…”

Section: Diagonsismentioning

confidence: 99%

Malignant biliary obstruction due to metastatic non-hepato-pancreato-biliary cancer

Okamoto¹

2022

WJG

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Malignant biliary obstruction generally results from primary malignancies of the pancreatic head, bile duct, gallbladder, liver, and ampulla of Vater. Metastatic lesions from other primaries to these organs or nearby lymph nodes are rarer causes of biliary obstruction. The most common primaries include renal cancer, lung cancer, gastric cancer, colorectal cancer, breast cancer, lymphoma, and melanoma. They may be difficult to differentiate from primary hepato-pancreato-biliary cancer based on imaging studies, or even on biopsy. There is also no consensus on the optimal method of treatment, including the feasibility and effectiveness of endoscopic intervention or surgery. A thorough review of the literature on pancreato-biliary metastases and malignant biliary obstruction due to metastatic non-hepato-pancreato-biliary cancer is presented. The diagnostic modality and clinical characteristics may differ significantly depending on the type of primary cancer. Different primaries also cause malignant biliary obstruction in different ways, including direct invasion, pancreatic or biliary metastasis, hilar lymph node metastasis, liver metastasis, and peritoneal carcinomatosis. Metastasectomy may hold promise for some types of pancreato-biliary metastases. This review aims to elucidate the current knowledge in this area, which has received sparse attention in the past. The aging population, advances in diagnostic imaging, and improved treatment options may lead to an increase in these rare occurrences going forward.

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Metastatic neoplasms to the pancreas diagnosed by fine‐needle aspiration/biopsy cytology: A 15‐year retrospective analysis

Cited by 23 publications

References 39 publications

Metastatic tumors to the pancreas: Balancing clinical impression with cytology findings

Metastatic tumors to the pancreas: Balancing clinical impression with cytology findings

Merkel Cell Carcinoma With Isolated Pancreatic Metastasis

Malignant biliary obstruction due to metastatic non-hepato-pancreato-biliary cancer

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