title: Role of endoscopic ultrasonography in evaluation of metastatic lesions to the pancreas: a tertiary cancer center experience.
abstract: OBJECTIVE
  Metastatic lesions to the pancreas pose diagnostic challenges with regards to their differentiation from primary pancreatic cancer. Data on the yield of endoscopic ultrasonography (EUS)-guided fine-needle aspiration in detection of these lesions are limited.
  
  
  METHODS
  This is a retrospective review of 23 patients referred to a tertiary referral center for further evaluation of suspected pancreatic metastases. Main outcome measures were diagnostic yield of endoscopic ultrasonography-guided fine-needle aspiration in evaluation of metastatic lesions to the pancreas.
  
  
  RESULTS
  Of 644 patients, 23 (3.6%) undergoing EUS of the pancreas were diagnosed to have metastatic disease to the pancreas based on clinical, radiological, and cytological results. Mean (SD) age was 64.3 (11.7) years. Of the 23 patients, 18 (78.3%) were asymptomatic. Mean (SD) size of lesion on EUS was 39.1 (19.9) mm. A diagnosis of malignant lesion was made in 21 of 23 cases, with a diagnostic accuracy of 91.3%.
  
  
  CONCLUSIONS
  Metastatic lesions to the pancreas present as incidental, solitary mass lesions on staging or surveillance imaging. Endoscopic ultrasonography-guided fine-needle aspiration is an important tool in the characterization and further differentiation of metastatic lesions to the pancreas from primary pancreatic cancer.
authors.affiliation: Department of Gastroenterology, University of Texas-MD Anderson Cancer Center, Houston, TX 77030, USA.
authors.forename: Muslim
authors.initials: M
authors.lastname: Atiq
authors.forename: Manoop S
authors.initials: MS
authors.lastname: Bhutani
authors.forename: William A
authors.initials: WA
authors.lastname: Ross
authors.forename: Gottumukkala S
authors.initials: GS
authors.lastname: Raju
authors.forename: Yun
authors.initials: Y
authors.lastname: Gong
authors.forename: Eric P
authors.initials: EP
authors.lastname: Tamm
authors.forename: Milind
authors.initials: M
authors.lastname: Javle
authors.forename: Xuemei
authors.initials: X
authors.lastname: Wang
authors.forename: Jeffrey H
authors.initials: JH
authors.lastname: Lee
mesh_terms: D000368:Aged; D003110:Colonic Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D003937:Diagnosis, Differential; D019160:Endosonography / Q000379:methods*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D008175:Lung Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008545:Melanoma / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D008875:Middle Aged; D010179:Pancreas / Q000000981:diagnostic imaging* / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000556:secondary; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D062606:Tertiary Care Centers