title: Accuracy of endoscopic ultrasound-guided fine-needle aspiration in the suspicion of pancreatic metastases.
abstract: BACKGROUND
  Metastases to the pancreas are rare, and usually mistaken for primary pancreatic cancers. This study aimed to describe the histology results of solid pancreatic tumours obtained by endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for diagnosis of metastases to the pancreas.
  
  
  METHODS
  In a retrospective review, patients with pancreatic solid tumours and history of previous extrapancreatic cancer underwent EUS-FNA from January/1997 to December/2010. Most patients were followed-up until death and some of them were still alive at the end of the study. The performance of EUS-FNA for diagnosis of pancreatic metastases was analyzed. Symptoms, time frame between primary tumour diagnosis and the finding of metastases, and survival after diagnosis were also analyzed.
  
  
  RESULTS
  37 patients underwent EUS-FNA for probable pancreas metastases. Most cases (65%) presented with symptoms, especially upper abdominal pain (46%). Median time between detection of the first tumour and the finding of pancreatic metastases was 36 months. Metastases were confirmed in 32 (1.6%) cases, 30 of them by EUS-FNA, and 2 by surgery. Other 5 cases were non-metastatic. Most metastases were from lymphoma, colon, lung, and kidney. Twelve (32%) patients were submitted to surgery. Median survival after diagnosis of pancreatic metastases was 9 months, with no difference of survival between surgical and non-surgical cases. Sensitivity, specificity, positive and negative predictive values, and accuracy of EUS-FNA with histology analysis of the specimens for diagnosis of pancreatic metastases were, respectively, 93.8%, 60%, 93.8%, 60% and 89%.
  
  
  CONCLUSIONS
  EUS-FNA with histology of the specimens is a sensitive and accurate method for definitive diagnosis of metastatic disease in patients with a previous history of extrapancreatic malignancies.
authors.forename: José Celso
authors.initials: JC
authors.lastname: Ardengh
authors.forename: César Vivian
authors.initials: CV
authors.lastname: Lopes
authors.forename: Rafael
authors.initials: R
authors.lastname: Kemp
authors.forename: Filadélfio
authors.initials: F
authors.lastname: Venco
authors.forename: Eder Rios
authors.initials: ER
authors.lastname: de Lima-Filho
authors.forename: José Sebastião
authors.initials: JS
authors.lastname: dos Santos
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000473:pathology* / Q000556:secondary* / Q000601:surgery; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D016019:Survival Analysis