한국간담췌외과학회지 (Annals of Hepato-Biliary-Pancreatic Surgery)

  • 제26권1호
  • /
  • Pages.91-97
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  • 2022
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  • 2508-5778(pISSN)
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  • 2508-5859(eISSN)
한국간담췌외과학회 (The Korean Association of Hepato-Biliary-Pancreatic Surgery)
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Metastatic tumors to the pancreas: Balancing clinical impression with cytology findings

  • Mohamed A. Abdallah (Department of Internal Medicine, University of South Dakota Sanford School of Medicine) ;
  • Kimberlee Bohy (Department of Pathology, University of South Dakota Sanford School of Medicine) ;
  • Ashwani Singal (Department of Internal Medicine, University of South Dakota Sanford School of Medicine) ;
  • Chencheng Xie (Department of Internal Medicine, University of South Dakota Sanford School of Medicine) ;
  • Bhaveshkumar Patel (Department of Internal Medicine, University of South Dakota Sanford School of Medicine) ;
  • Morgan E. Nelson (Department of Internal Medicine, University of South Dakota Sanford School of Medicine) ;
  • Jonathan Bleeker (Department of Internal Medicine, University of South Dakota Sanford School of Medicine) ;
  • Ryan Askeland (Department of Pathology, University of South Dakota Sanford School of Medicine) ;
  • Ammar Abdullah (Department of Internal Medicine, University of South Dakota Sanford School of Medicine) ;
  • Khalil Aloreidi (Department of Internal Medicine, University of South Dakota Sanford School of Medicine) ;
  • Muslim Atiq (Department of Internal Medicine, University of South Dakota Sanford School of Medicine)
  • 투고 : 2021.07.26
  • 심사 : 2021.10.19
  • 발행 : 2022.02.28
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초록

Backgrounds/Aims: Metastatic lesions of the pancreas (PMET) account for 1%-5% of all malignant solid pancreatic lesions (SPL). In this study we evaluated the utility of endoscopic ultrasonography with fine needle aspiration (EUS-FNA) in diagnosing PMET. Methods: Patients who underwent EUS-FNA at a community referral center between 2011-2017 for SPL were identified. Clinical, radiologic, and EUS-FNA features of those with PMET were compared to those with primary solid tumors of the pancreas: pancreatic adenocarcinoma (PDAC) and neuroendocrine tumors (PNET). Results: A total of 191 patients were diagnosed with solid pancreatic malignancy using EUS-FNA: 156 PDAC, 27 PNET, and eight (4.2%) had PMET. Patients with PMET were less likely to have abdominal pain (25.0% vs. 76.3% vs. 48.2%; p < 0.01) or obstructive jaundice (37.5% vs. 58.3% vs. 0%; p < 0.01) compared to PDAC and PNET. Those with PMET were more likely to have mass lesions with/without biliary or pancreatic ductal dilatations (100% vs. 86.5% vs. 85.2%; p < 0.01) and lower CA19-9 (82.5 ± 43.21 U/mL vs. 4,639.30 ± 11,489.68 U/mL vs. 10.50 ± 10.89 U/mL; p < 0.01) compared to PDAC and PNET. Endosonographic features were similar among all groups. Seven (87.5%) patients with PMET had a personal history of malignancy prior to PMET diagnosis. The primary malignancy was renal cell carcinoma in five PMET. Conclusions: PMET are exceedingly rare, comprising less than 5% of SLP. Patients with PMET are less likely to present with symptoms and mostly identified by surveillance imaging for the primary malignancy.

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과제정보

This manuscript was presented as an abstract at the American Journal of Gastroenterology meeting in San Antonio, Texas, USA in October 2019 (abstract number 2791, volume 114).

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