Review
Copyright ©The Author(s) 2022.
World J Gastroenterol. Mar 14, 2022; 28(10): 985-1008
Published online Mar 14, 2022. doi: 10.3748/wjg.v28.i10.985
Table 1 Computed tomography findings of pancreatic metastases



Primary Malignancy




Characteristics
Ref.
Year
Cases
Renal
Lung
Breast
Stomach
Colon
Sarcoma
Melanoma
Ovary
Thyroid
Other
Solitary mass
Multiple nodules
Diffuse involvement
Ferrozzi et al[14]199720263312211127
Klein et al [15]1998662015845421752113
Tsitouridis et al [16]200911173731
Angelleli et al [17]2012178432791
Shi et al [18]201518375 (stomach+colon)21126
Choi et al [19]201536172571112297
Galia et al [20]2018246821439132
Total19257491912811756131275114
% of total30%26%10%7%5%6%4%3%3%7%66%27%7%
Table 2 Relative frequency of pancreatic metastases by modality/procedure
Modality/procedure
Total cases
Renal
Lung
Breast
Stomach
Colon
Sarcoma
Melanoma
Ovary
Thyroid
Esophagus
Lymphoma
Other
CT19230%26%10%7%5%6%4%3%3%0%0%7%
ERCP3071%3%4%27%38%0%2%2%0%2%1%20%
EUS-FNA51540%20%6%2%9%3%10%3%1%2%0%3%
Surgery39963%3%3%3%6%7%4%5%0%0%0%6%
Autopsy1843%28%4%22%1%2%1%2%1%0%5%31%
Weighted average1159733%14%5%10%12%4%5%3%1%1%1%11%
Table 3 Characteristics of malignant biliary obstruction caused by various primary malignancies

Unique characteristics/diagnostic clues
Major causes of malignant biliary obstruction
Renal cell carcinomaEnhancing lesion on imaging. Most pancreatic metastases resectable and associated with a good prognosis. Can arise up to 32 years after diagnosis of primary tumorPancreatic metastasis (biliary obstruction rare)
Lung cancerMost reported in small cell lung cancer. Possible primary small cell biliary cancerPancreatic metastasis
Gastric cancerMost cases present after surgery for Borrmann 3 antral lesions. Possible need for double stenting due to gastric outlet obstructionLymph nodes, liver metastasis, direct invasion
Colorectal cancerIntraductal growth can mimic bile duct cancerLiver metastasis, lymph nodes
Breast cancerMost reported in invasive lobular carcinoma. Possible duodenal obstructionCan arise up to 32 years after diagnosis of primary tumorLymph nodes, pancreatic metastasis
MelanomaPossible pancreato-biliary primaryPancreatic metastasis
LymphomaMore common in non-Hodgkin's lymphoma. Possible pancreato-biliary primaryLymph nodes
SarcomaPossible pancreato-biliary primaryPancreatic metastasis