title: Secondary tumors of the pancreas diagnosed by endoscopic ultrasound-guided fine-needle aspiration: a 10-year experience.
abstract: Determining whether a pancreatic mass is a primary or secondary neoplasm is necessary for appropriate treatment. We reviewed our experience using endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for diagnosis of pancreatic tumors to identify clinical and cytopathologic characteristics of metastatic disease. We reviewed all cases of tumors metastatic to the pancreas evaluated at The University of Texas MD Anderson Cancer Center and The Methodist Hospital in Houston, Texas during the period from 2002 to 2012. The review included cytologic specimens, clinical history, radiologic findings, primary tumor type, and clinical follow-up. We identified 66 patients with disease metastatic to the pancreas for which cytologic material was available: 38 (58%) men and 28 (42%) women, with an average age of 63 years (range, 40-89 years). Most metastases (98%) were single lesions, and nearly half were located in the head of the pancreas (30/66). The most common site of origin for these metastases was kidney (27 [41%] cases). Follow-up information was available for 65 (98%) patients, and duration of follow-up ranged from <1 to 10 years (mean, 2.3 years). Thirty-three patients (50%) were alive at the time of the most recent follow-up contact. Of the 25 patients with metastatic renal cell carcinoma, clear cell type, 19 (76%) were alive at the time of the most recent follow-up. It was concluded that metastases may mimic primary pancreatic carcinomas both clinically and cytologically. Ancillary studies in conjunction with clinical history are necessary for the accurate diagnosis of FNAs of secondary pancreatic tumors.
authors.affiliation: Department of Pathology and Laboratory Medicine, Section of Cytopathology, The University of Texas MD Anderson Cancer Center and Department of Pathology and Genomic Medicine The Methodist Hospital, Houston, Texas.
authors.forename: Lindsay
authors.initials: L
authors.lastname: Waters
authors.forename: Quisheng
authors.initials: Q
authors.lastname: Si
authors.forename: Nancy
authors.initials: N
authors.lastname: Caraway
authors.forename: Dina
authors.initials: D
authors.lastname: Mody
authors.forename: Gregg
authors.initials: G
authors.lastname: Staerkel
authors.forename: Nour
authors.initials: N
authors.lastname: Sneige
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000473:pathology* / Q000556:secondary; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000473:pathology*
keywords: EUS-FNA; metastatic tumors; pancreas; pancreatic neoplasms; secondary tumors of pancreas