• Diagnosis
• Endoscopic ultrasound
• Metastasis
• Pancreas
• Pancreatic mass

• cancer
• metastasis
• oncology
• pancreas
• surgery

• Isolated pancreatic metastasis
• Lung primary
• Pancreatic metastasis
• Solitary metastasis
• Unusual metastasis

Pancreatic metastases from squamous cell lung carcinoma (SCLC) are unusual. These lesions are often asymptomatic and detected incidentally or during follow-up investigations, occasionally several years after removal of the primary tumor.

A 56-year-old male with SCLC developed jaundice 1 mo after the cancer diagnosis. An abdominal computed tomography (CT) scan showed a mass in the pancreatic head with distention of both intra- and extrahepatic biliary ducts. Endoscopic retrograde cholangiopancreatography and sphincterotomy were performed first, culminating with plastic biliary stent placement. Cytological examination of the pancreatic mass sample collected by fine-needle aspiration (FNA) under endoscopic ultrasound (EUS) guidance revealed the presence of malignant cells compatible with well-differentiated squamous cell carcinoma. After liver function normalized, chemotherapy was initiated with carboplatin and paclitaxel; however, 4 d later, the patient presented dysphagia. Cervico-thoraco-abdominal CT showed tracheoesophageal fistula and stent migration. After replacement with a 10 cm/10 mm uncovered metallic biliary stent and treatment of the tracheoesophageal fistula with a fully covered esophageal stent, the patient was able to start oral feeding progressively. He died 9 mo after the initial diagnosis.

The diagnosis of pancreatic metastasis from SCLC is challenging for clinicians. EUS-FNA is the primary exam for confirmatory diagnosis.

• Squamous cell lung carcinoma
• Pancreatic metastasis
• Jaundice
• Esotracheal fistula
• Ultrasound endoscopy
• Case report

• Locally advanced pancreatic metastasis
• Pancreatic metastases
• Recurrent cell carcinoma pancreatic metastasis
• Renal cell carcinoma pancreatic metastasis

This study aimed to determine the outcome of pancreatic metastatic renal cell carcinoma (PmRCC) after treatment and share the relevent results.

In total, 13 patients with PmRCC were diagnosed and treated in our institution from December 2013 to October 2017. We retrospectively reviewed the records and analyzed the patient demographics, perioperative outcomes, and overall survival. Simultaneously, our experience including treatment and misdiagnosis was shared.

The median time between nephrectomy and reoperation for pancreatic recurrence was 11 years (range 1–20 years). Four patients had multiple tumors and nine patients had solitary tumor. Five patients accepted distal pancreatectomy, and five patients underwent pancreaticoduodenectomy. One patient underwent total pancreatectomy, one patient underwent duodenum-preserving pancreatic head resection plus distal pancreatectomy, and one patient underwent exploratory laparotomy and gastrointestinal bypass due to widespread metastasis with clear obstructive symptoms. The misdiagnosis rate of preoperative diagnosis at our center was 69.2% (9/13). The median follow-up duration was 26 months (range 7–53 months, until June 2018). By the end of follow-up, 12 patients were alive and one patient died of gastrointestinal bleeding within 1 month after surgery.

PmRCCs are uncommon, but pancreatic metastasectomy has a relatively good prognosis and may, therefore, be a good therapeutic choice for patients with PmRCCs. Because PmRCC occurs long after the primary tumor resection, long-term follow-up is necessary. Besides, detailed medical history and specific manifestation in imaging features could contribute to avoiding misdiagnosis.

• Metastatic renal cell carcinoma
• Pancreatic metastasectomy
• Surgical resection

• Metastasis
• Myxoid liposarcoma
• Pancreas
• Pancreatectomy
• Sarcoma

• Adult
• Disease-Free Survival
• Female
• Humans
• Liposarcoma, Myxoid/pathology
• Neoplasm Recurrence, Local/pathology
• Pancreatic Neoplasms/pathology
• Thigh/pathology

• 81502493 National Natural Science Foundation of China (CN)
• ZYLX101814 Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support (CN)

Pancreatic metastases are rare, <2% of all pancreatic neoplasia. This is the first case of pancreatic metastasis from adamantinoma, a rare, low grade and slow growing tumor which is frequently localized in long bones. We describe a case of a 45-year-old woman presenting with increased bilirubin level. Computed tomography and ecoendoscopic ultra sonography revealed a pancreatic head mass. Fine-needle aspiration biopsy was consistent with metastatic adamantinoma. The patient was submitted to a standard pancreaticoduodenectomy. As in the case presented, standard pancreatic resections are safe and feasible options to treat non-pancreatic primary tumor improving patient’s survival and quality of life.

• diagnosis
• genetic mutation detection
• pancreatic metastasectomy
• pancreatic metastases

Primary mesenchymal tumors of the pancreas are rare, with leiomyosarcomas the most encountered entities among the pancreatic sarcomas. With few exceptions, single case reports published over the last six decades constitute the entire scientific literature on this topic. Thus, evidence regarding clinical decision-making is scant.

Based on a case report and an extensive literature search in PubMed, we discuss the clinical aspects and current management of this rare malignancy.

We identified only two papers with more than a single case presentation; these institutional patient series were limited to five and nine patients. Additionally, a few papers sought to summarize the individual case reports published in the English and/or Chinese language. The clinical presentation is rather non-specific. Moreover, modern imaging modalities are insufficiently accurate to diagnose leiomyosarcoma of the pancreas. Treatment goals include a complete resection with free margins. Proper morphologic examination using immunohistochemistry and the application of a grading system are clinically important for prognostication. The efficacy of adjuvant treatments has not been established.

Primary pancreatic leiomyosarcoma is extremely rare, and the scientific literature is primarily based on single case reports. Conclusions on management and prognosis should be drawn with caution. A multidisciplinary team consultation is warranted to discuss a thorough individual treatment plan based on the available scientific literature, despite its low evidence level.

• Leiomyosarcoma
• Mesenchymal tumor
• Pancreas
• Review

• gastrointestinal bleeding
• metastasis
• non-small cell lung cancer
• pancreas

• carcinoma
• endoscopic ultrasound (EUS)
• mesenchymal chondrosarcoma
• pancreaticobiliary
• rapid onsite evaluation

• metastases
• pancreas
• renal cell carcinoma
• surgery

Pancreatic metastases from other primary malignancies are a rare entity. By far, the most common primary cancer site resulting in an isolated pancreatic metastasis is the kidney, followed by colorectal cancer, melanoma, breast cancer, lung carcinoma and sarcoma. Only few data on the surgical outcome of pancreatic resections performed for metastases from other primary tumor have been published, and there are no guidelines to address the surgical treatment for these patients. In this study, we performed a review of the published literature, focusing on the early and long-term results of surgery for the most frequent primary tumors metastasizing to the pancreas. Results for the Literature’s analysis show that in last years an increasing number of surgical resections have been performed in selected patients with limited pancreatic disease. Pancreatic resection for metastatic disease can be performed with acceptable mortality and morbidity rates. The usefulness of pancreatic resection is mainly linked to the biology of the primary tumor metastasizing to the pancreas. The benefit of metastasectomy in terms of patient survival has been observed for metastases from renal cell cancer, while for other primary tumors, such as lung and breast cancers, the role of surgery is mainly palliative.

• Pancreas
• Pancreatic neoplasms/secondary
• Pancreatectomy
• Renal cell cancer
• Breast cancer
• Melanoma
• Sarcoma
• Lung carcinoma

• carcinoma
• renal cell
• neoplasm metastasis
• pancreatectomy
• treatment outcome

• Adult
• Aged
• Aged, 80 and over
• Blood Vessels/pathology
• Carcinoma, Renal Cell/secondary
• Carcinoma, Renal Cell/surgery
• Female
• Humans
• Kidney Neoplasms/pathology
• Kidney Neoplasms/surgery
• Lymphatic Metastasis
• Male
• Middle Aged
• Neoplasm Invasiveness
• Neoplasm, Residual
• Pancreatectomy/adverse effects
• Pancreatic Neoplasms/secondary
• Pancreatic Neoplasms/surgery
• Pancreaticoduodenectomy/adverse effects
• Retrospective Studies
• Survival Rate
• Time Factors
• Treatment Outcome

• P30 CA006973 NCI NIH HHS

We have reviewed the electronic biopsies database files of the Department of Surgical Pathology, Fundación Jiménez Díaz in Madrid (Spain). In this time period (1998–2010) we have found 3 pancreatic metastasis and 5 splenic metastasis. Two of the pancreatic metastases were originated in clear cell renal cell carcinomas. The last pancreatic metastasis was from a malignant cutaneous melanoma diagnosed and treated 8 years before. As for splenic metastasis, three of them were diagnosed during the abdominal surgery for primary therapy of the tumour (2 ovaries and one endometrium), while the remaining 2 corresponded to metastasis from a lung primary diagnosed 1 year before and a colonic primary diagnosed 6 years before. The patients with splenic metastasis died on the short term with progression of the disease despite resection of the splenic lesions, while the patients with pancreatic metastasis have survived longer.

• metastasectomy
• metastasis
• outcome.
• pancreas
• spleen