THE ROLE OF ENDOSCOPIC ULTRASOUND-GUIDED FINE-NEEDLE ASPIRATION (EUS-FNA) IN METASTATIC TUMORS IN THE PANCREAS

Aims Metastases to the pancreas (MP) are rare, frequently presenting with no specific clinical signs or symptoms and discovered incidentally, therefore difficult to characterize and differenziate from a primitive pancreatic tumor. EUS-FNA is well recognized as a useful diagnostic tool in this setting. However, data regarding the diagnostic significance of EUS-FNA in patients with MP has not been well established and few studies have explored this aspect. Our aim is to investigate first the role of EUS-FNA and secondly the impact of some EUS findings in supporting the suspected diagnosis of MP.

Methods The study population consisted of 640 consecutive patients referred at our tertiary center with instrumental finding of pancreatic masses requiring EUS-FNA.

Results The overall prevalence of MP was 3.75%. Carcinoma was the prevalent histotype (87.5%), followed by melanoma (8.3%) and condrosarcoma (4.2%). The most common primary tumor sites were the kidney (41.7%) and the colonrectum (20.9%), followed by the lung (8.3%), the skin (8.3%) and the liver (8.3%). MP most often showed hypoecoic ecogenicity (95.8%), without septa/anechoic areas (70.8%), and appeared avascular (58.3%). The morphology was mainly circular (95.8%) with well-definited margins (75%). The infiltration of the vascular axis, the dilation of the main pancreatic duct or the involvement of common bile duct were rarely associated with MP (25%; 33.4% and 12.5%, respectively).

Conclusions EUS-FNA has been confirmed a useful diagnostic tool for MP. Although larger multicenter studies are needed to confirm our data, our findings likely suggest the potential predictive significance of EUS features for the metastatic origin, too

Publication History

Article published online:
14 April 2022