title: MDCT findings of pancreatic metastases according to primary tumors.
abstract: OBJECTIVE
  To describe the clinical and MDCT findings of metastatic pancreatic tumors (MPTs) from various primary malignancies and to determine whether there are characteristic imaging features of MPTs according to the various histologies of primary tumors.
  
  
  METHODS
  Thirty-six patients with pathologically proven MPTs who underwent MDCT were retrospectively enrolled. Mean survival and factors associated with prolonged survival were analyzed using multivariate Cox regression analysis. MDCT was analyzed for the location, number, margin, and pattern and degree of enhancements of MPTs and main pancreatic duct (MPD) dilatations. Significant differences in CT features among the various histologies of MPTs were determined using the χ (2) or Fisher's exact test.
  
  
  RESULTS
  The most common primary tumors metastasized to the pancreas were renal cell carcinomas (RCC) (n = 17), gastric cancers (n = 7), and colorectal cancers (n = 5). Mean survival was significantly different between RCC (106.7 months) and non-RCC (25.1 months) metastases (P < 0.001). A primary tumor of RCC was the only factor associated with prolonged survival (hazard ratio: 0.106, P = 0.003). On MDCT, pancreatic metastases from RCC were frequently multifocal, located at the center of the pancreas, usually homogeneous and well-defined with early wash-in and persistent enhancement; non-RCC metastases tended to be solitary, located off-center (P < 0.05), and appeared as heterogeneous, ill-defined nodules with persistent low attenuation (P < 0.05).
  
  
  CONCLUSIONS
  Various non-RCC tumors as well as RCCs metastasize to the pancreas but a primary tumor of RCC is the only factor associated with prolonged survival. MDCT features of MPTs are significantly different between the RCC and non-RCC metastases, potentially aiding in their differentiation and selection of the most appropriate management options for these patients.
authors.affiliation: Department of Radiology, Institute of Radiation Medicine, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul, 110-744, Korea.
authors.forename: Tae Won
authors.initials: TW
authors.lastname: Choi
authors.forename: Se Hyung
authors.initials: SH
authors.lastname: Kim
authors.forename: Cheong-Il
authors.initials: CI
authors.lastname: Shin
authors.forename: Joon Koo
authors.initials: JK
authors.lastname: Han
authors.forename: Byung Ihn
authors.initials: BI
authors.lastname: Choi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000473:pathology*; D015179:Colorectal Neoplasms / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D010179:Pancreas / Q000000981:diagnostic imaging; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology*; D016019:Survival Analysis