An Unusual Case of Pancreatic Metastasis from Squamous Cell Carcinoma of the Lung Diagnosed by EUS-Guided Fine Needle Biopsy

Ishikawa, Takuya; Hirooka, Yoshiki; Teman, Carolin; Goto, Hidemi; Belletrutti, Paul J.

doi:10.1155/2017/3212056

Cited by 9 publications

(9 citation statements)

References 9 publications

(10 reference statements)

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“…Cytomorphology alone is insufficient to distinguish between primary pancreatic cancer and metastatic cancer, but multiple immunohistochemical stain such as thyroid transcription factor on tissue specimen allows for this distinction, hence FNB is usually preferred. 10,11 However, in our case, there were no enlarged lymph nodes observed around the pancreas nor vascular invasion other than splenic vein invasion. Hence, only FNA was performed, but sufficient core tissue was not obtained.…”

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confidence: 58%

“…2,7 In a recent study of single institution in Korea, 58% of patients with metastasis to pancreas were found at follow-up imaging without any symptoms, and 42% were found with related symptoms. 6 On EUS evaluation, pancreas metastatic lesion is known to show relatively well-define borders compared to primary pancreatic cancer, 10 but there have been studies that state that it is difficult to distinguish between metastatic lesion and primary pancreatic cancer. Therefore, pathological confirmation is the recommended diagnostic tool in this case.…”

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confidence: 99%

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Lung Cancer Recurrence with Solitary Pancreatic Metastasis Mimicking Primary Pancreatic Cancer

Kim¹,

Lee²,

Bae³

et al. 2018

Korean J Pancreas Biliary Tract

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Pancreas metastasis of primary lung cancer is known to be very rare and if it occurs, most cases are disseminated malignant status and do not affect therapeutic plan. We experienced a case of lung cancer recurrence with solitary pancreas metastasis and mimicks primary pancreatic cancer. A 54-year old man was admitted to the hospital for further evaluation of pancreatic solitary mass. He underwent left pneumonectomy and adjuvant chemotherapy for treatment of lung adenocarcinoma 3 years ago. After surgical treatment, the lesion was confirmed metastatic adenocarcinoma of lung cancer origin. He was discharged and followed up for 24 months without recurrence.

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confidence: 58%

mentioning

confidence: 99%

Lung Cancer Recurrence with Solitary Pancreatic Metastasis Mimicking Primary Pancreatic Cancer

Kim¹,

Lee²,

Bae³

et al. 2018

Korean J Pancreas Biliary Tract

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“…EUS-guided FNA/biopsy is an established and widely used tissue sampling technique for the pancreas[8], and there is no doubt that this technique will provide promising results in the diagnosis of pancreatic diseases. However, the amount of specimens that can be obtained with a conventional FNA needle is limited and can preclude diagnoses that require detailed histological assessment, such as AIP [9] or neoplasms with atypical histology [10]. In this study, we have shown that the Franseen needle obtained significantly larger samples than were obtained with a conventional FNA needle, even from the pancreatic head or uncinate process, which have been difficult to sample with existing core needles [11–15].…”

Section: Discussionmentioning

confidence: 99%

Clinical Impact of EUS-Guided Fine Needle Biopsy Using a Novel Franseen Needle for Histological Assessment of Pancreatic Diseases

Ishikawa

Kawashima

Ohno

et al. 2019

Canadian Journal of Gastroenterology and Hepatology

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Background and Aims. Several studies have shown the benefits of endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) using a Franseen needle for histological assessment. However, studies focusing on pancreatic diseases are limited and the safety of this method has not been well assessed. We aimed to assess the current status and issues of EUS-FNB in the diagnosis of pancreatic diseases. Materials and Methods. We retrospectively reviewed 87 consecutive EUS-FNB specimens using either a 22-gauge Franseen needle (Group A, N = 51) or a conventional 22-gauge fine-needle aspiration needle (Group B, N = 36) for pancreatic diseases, and the diagnostic accuracy and safety were compared. Final diagnoses were obtained based on surgical pathology or a minimum six-month clinical follow-up. Results. Although the diagnostic accuracy for malignancy was 96.1% in Group A versus 88.9% in Group B, with no statistically significant difference (P = 0.19), the median sample area was significantly larger in Group A (4.07 versus 1.31mm2, P < 0.0001). There were no differences between the two needles in the locations from which the specimens were obtained. Adverse events occurred in one case (2%) in Group A (mild pancreatitis) and none in Group B with no statistical significance (P = 0.586). Although there was no case of bleeding defined as adverse events, 2 cases in Group A showed active bleeding during the procedure with increase in the echo-free space, which required CT scanning to rule out extravasation. Eventually, the bleeding stopped spontaneously. Conclusions. Given its guaranteed ability to obtain core specimens and comparable safety, and although the risk of bleeding should be kept in mind, EUS-FNB using a Franseen needle is likely to become a standard procedure for obtaining pancreatic tissue in the near future.

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“…As a result, imaging studies can only precisely evaluate the stage of disease, whereas histopathological examination can more accurately distinguish primary from metastatic pancreatic lesions (12). Percutaneous fine-needle biopsy of the pancreatic tumor, guided by either CT or EUS, can help establish a solid diagnosis (13,14). Following meticulous evaluation of preoperative imaging studies and assessment of the patient's clinical condition, surgical teams can determine whether the patient is eligible to undergo resection with curative intent (10).…”

Section: Discussionmentioning

confidence: 99%

“…According to their results, the mean postoperative survival following pancreatic resection (8 patients; 61.5%) was 28.9 months (range, 1-91 months) compared with 2 months (range, 5-30 months) for patients who were administered palliative chemotherapy and/or radiation (5 patients; 38.5%) (10). However, in the case of metastatic lesions from primary squamous cell lung carcinoma, the evidence is poor and surgical treatment is rarely attempted due to extensive or unresectable pancreatic disease (6,7,10,14).…”

Section: Discussionmentioning

confidence: 99%

Metastatic squamous cell carcinoma to the pancreas: Report of an extremely rare case

et al. 2018

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Secondary pancreatic lesions are very uncommon. Resection of these metastatic lesions with a curative intent has been reported in selected patients; however, the survival benefit from these procedures has yet to be clearly determined. A 78-year-old male patient presented to our department with obstructive jaundice. Three years prior to presentation the patient had undergone right pneumonectomy, due to stage IIA, low-grade squamous cell lung carcinoma. After resection, the patient received adjuvant chemotherapy, with no evidence of local or systemic recurrence over the following 3 years. Abdominal computer tomography on admission revealed a 3-cm lesion located at the head of the pancreas, causing biliary obstruction. Endoscopic ultrasound biopsy revealed malignant cells, suspicious for squamous cell carcinoma. Due to the limited extent of the metastatic disease and in view of the patient's good condition, surgical resection was proposed and the patient successfully underwent pancreaticoduodenectomy. Histological examination of the resected specimen confirmed a squamous cell carcinoma, with an immunochemical profile similar to that of the primary lung tumor. Therefore, pancreatic resection with curative intent may be feasible in selected patients with secondary metastatic tumors. However, further studies are required in order to determine the benefit of these major procedures in terms of survival outcomes.

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An Unusual Case of Pancreatic Metastasis from Squamous Cell Carcinoma of the Lung Diagnosed by EUS-Guided Fine Needle Biopsy

Cited by 9 publications

References 9 publications

Lung Cancer Recurrence with Solitary Pancreatic Metastasis Mimicking Primary Pancreatic Cancer

Lung Cancer Recurrence with Solitary Pancreatic Metastasis Mimicking Primary Pancreatic Cancer

Clinical Impact of EUS-Guided Fine Needle Biopsy Using a Novel Franseen Needle for Histological Assessment of Pancreatic Diseases

Metastatic squamous cell carcinoma to the pancreas: Report of an extremely rare case

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