SECONDARY TUMORS OF THE PANCREAS: A MULTICENTER ANALYSIS OF CLINICOPATHOLOGICAL AND ENDOSONOGRAPHIC FEATURES

Aims Many extrapancreatic tumors may secondarily involve the pancreas(3-12%). However, most evidences are based on retrospective analysis of autopsies and surgical series.The aim of this study was to describe clinical, endosonographic,and pathological features of secondary tumors of the pancreas,along with their therapeutic approach and related outcomes.

Methods We performed a retrospective review of all consecutive histologically confirmed secondary pancreatic tumors referred to five Italian centers between 2010 and 2021.Demographic,clinical,treatment and outcome data were collected.The EUS-related characteristics of the lesions(size,location,number of focal masses, echotexture and vascularization) and the tissue acquisition procedures(needle, passages, histology) were also collected.

Results One-hundred-sixteen patients (Male/Female: 69/47; mean age: 66.7±10.1 years) with 236 histologically confirmed pancreatic metastases were included in the analysis,with kidney being the most common primary neoplastic site. EUS was performed in order to confirm the diagnosis in 205 pancreatic lesions (101 patients),mostly solitary (n=59),hypoechoic (n=95) hyper-vascular (n=60) with well-defined borders (n=52).EUS-guided fine needle sampling was performed in 94 patients with an overall accuracy of 97.9% (2.4±1.3 needle passes) (range: 1–4). A histologic evaluation was possible in 88.3% of patients and the final diagnosis was obtained in all cases.When cytology alone was performed, the final diagnosis was obtained in the 83.3% of cases.Sixty-seven patients underwent either chemo- or radiation therapy.In 45 patients (38.8%) the surgical approach was attempted.

Conclusions Metastases to the pancreas are a possible occurrence in the natural history of various solid tumors. They are mostly solitary, hypoechoic,hyper-vascular lesions with well-defined borders,and EUS-guided sampling with fine needle biopsy (FNB) needles may be suggested.

Publication History

Article published online:
14 April 2022