title: Isolated metastasis of uterine leiomyosarcoma to the pancreas: Report of a case and review of the literature.
abstract: BACKGROUND
  Metastatic tumors of the pancreas are uncommon and rarely detectable clinically. Metastases to the pancreas are rare. We present a patient with pancreatic metastases from a leiomyosarcoma of the uterus and review the literature about the clinical features of pancreatic metastasis and its surgical management.
  
  
  METHODS
  A 40-year-old woman, who underwent hysterectomy, left oophorectomy, omentectomy and lymp node dissection for leiomyosarcoma of the uterus. At the follow up, the patient complained of non-specific abdominal discomfort. Preoperative diagnosis were pancreatic pseudocyst, cystadenoma or cystadenocarcinoma. At laparotomy, a cystic mass was found in the tail of the pancreas which was invased to the transverse colon mesenterium and the spleen. Distal pancreatectomy with splenectomy and transverse colon resection was performed. Histologically, the tumor was evaluated as poorly differentiated leiomyosarcoma.
  
  
  CONCLUSIONS
  Metastatic lesions of the pancreas are uncommon and less than 2% of all pancreatic malignancies. However a few cases of leiomyosarcoma with metastases to the pancreas have been reported in the literature. Before deciding that the lesion in the pancreas was metastasis, primary leiomyosarcoma of the pancreas had to be ruled out. Histologically, leiomyosarcoma of the pancreas contains interlacing spindle cells with varying degrees of atypia and pleomorphism. The surgical approach to the pancreatic metastases must be aimed complete excision of the tumor with a wide negative margin of clear tissue and maximum preservation of pancreatic remnant if possible.
  
  
  CONCLUSIONS
  In the absence of widespread metastatic disease, aggressive surgical approach with negative margins must be aimed.
authors.affiliation: T.C.S.B. Tepecik Teaching and Research Hospital, Department of General Surgery, Izmir, Turkey. Electronic address: surgeon0052@gmail.com.
authors.forename: Safak
authors.initials: S
authors.lastname: Ozturk
authors.affiliation: T.C.S.B. Tepecik Teaching and Research Hospital, Department of General Surgery, Izmir, Turkey.
authors.forename: Mutlu
authors.initials: M
authors.lastname: Unver
authors.affiliation: Ege University Faculty of Medicine, Department of Radiology, Izmir, Turkey.
authors.forename: Burcin Kibar
authors.initials: BK
authors.lastname: Ozturk
authors.affiliation: T.C.S.B. Tepecik Teaching and Research Hospital, Department of General Surgery, Izmir, Turkey.
authors.forename: Osman
authors.initials: O
authors.lastname: Bozbıyık
authors.affiliation: T.C.S.B. Tepecik Teaching and Research Hospital, Department of General Surgery, Izmir, Turkey.
authors.forename: Varlık
authors.initials: V
authors.lastname: Erol
authors.affiliation: T.C.S.B. Tepecik Teaching and Research Hospital, Department of General Surgery, Izmir, Turkey.
authors.forename: Eyup
authors.initials: E
authors.lastname: Kebabcı
authors.affiliation: T.C.S.B. Tepecik Teaching and Research Hospital, Department of General Surgery, Izmir, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Olmez
authors.affiliation: T.C.S.B. Tepecik Teaching and Research Hospital, Department of General Surgery, Izmir, Turkey.
authors.forename: Nihat
authors.initials: N
authors.lastname: Zalluhoglu
authors.affiliation: T.C.S.B. Tepecik Teaching and Research Hospital, Department of Pathology, Izmir, Turkey.
authors.forename: Umit
authors.initials: U
authors.lastname: Bayol
keywords: Adjuvant chemotherapy; Leiomyosarcoma; Pancreas; Pancreatectomy; Radiotherapy