EUS-FNA Diagnosis with Core Biopsy of Pancreatic Metastases from Primary Breast Cancer

Romanini, Samuel Galante; Serrano, Juan Pablo Román; Castro, Juliana Silveira Lima de; Torres, Isabela Trindade; Ingold, Alex; Borini, André Lucchiari; Zulske, Luiz Augusto S.; Matias, Maria Bruna Feitosa; Marchi, Jéssica Said de; Pulla, José Andres Sanchez; Ardengh, José Celso

doi:10.1155/2020/7136897

Cited by 5 publications

(9 citation statements)

References 8 publications

(15 reference statements)

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“…The second step in the diagnostic path of duodenal metastasis from BC is an EUS, which clearly describes the mucosal layer of the duodenum, especially in cases of strictures. Moreover, due to the nature of invasive lobular carcinoma and its pleomorphic cells infiltrating tissue, a fine-needle aspiration is fundamental to reach a correct histopathological diagnosis [15] . In our clinical case, diagnosis was hard to achieve due to unspecific abdominal complaints and no radiological evidence of neoplastic mass occupying the duodenum or pancreas.…”

Section: Discussionmentioning

confidence: 99%

A Rare Case of Duodenal Metastasis from Lobular Breast Cancer: From Diagnosis to Surgery

Barbieri¹,

Caraceni²,

Gentile³

et al. 2023

Case Rep Oncol

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Gastrointestinal tract breast cancer (BC) metastases represent a rare event and generally originate from the lobular subtype. Duodenal involvement was rarely described in previous case series. Abdominal symptoms are extremely unspecific and misleading. Diagnosis is challenging, and it consists of a few mandatory steps from radiological examinations to histological and immunohistochemical analyses. Here, we presented the clinical case of a 54-year-old postmenopausal woman who was hospitalized for vomiting and jaundice, presenting increased level of liver enzymes and minimal main bile duct and choledocus dilatation at abdominal ultrasonography. She underwent breast-conserving surgery and axillary lymph node dissection for stage IIIB lobular BC, 5 years before. Metastatic infiltration of the duodenal bulb originating from lobular BC was proven histologically, through fine-needle aspiration during endoscopic ultrasonography. Treatment was established after multidisciplinary team evaluation, based on the clinical status and prognosis of the patient. Pancreaticoduodenectomy was performed, and final histological examination confirmed the secondary localization of lobular BC, infiltrating the duodenal and gastric wall, pancreas parenchyma, and surrounding tissues. No metastatic lymph nodes were found. After surgery, the patient underwent first line of adjuvant systemic treatment with fulvestrant and ribociclib. After a follow-up of 21 months, the patient was in good clinical condition, without signs of locoregional or distant recurrence. This report stressed on the importance of a tailored therapeutic approach. Although systemic therapy generally represents the preferred option, surgery should not be excluded if an oncological radical resection can be performed achieving acceptable locoregional disease control.

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Section: Discussionmentioning

confidence: 99%

A Rare Case of Duodenal Metastasis from Lobular Breast Cancer: From Diagnosis to Surgery

Barbieri¹,

Caraceni²,

Gentile³

et al. 2023

Case Rep Oncol

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“…The most common sites of primary neoplasms that metastasise to the pancreas are kidney, lung, breast, colon and skin (in descending order) [ 8 , 9 ] and if the diagnosis is made on the metastasis, it gives it a worse prognosis. [ 7 ] The head of the pancreas is the most common site and usually presents as a single mass which could cause confusion with a primary tumor, especially in patients without history of prior malignancy.…”

Section: Discussionmentioning

confidence: 99%

Metastases to pancreas diagnosed by endoscopic ultrasound-guided fine-needle aspiration: A case series and review of imaging and cytologic features

Malacara,

Limón,

Quintana

et al. 2023

Cytojournal

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Fine-needle aspiration (FNA) is ideal for the diagnosis of pancreatic neoplasms with high precision. We described five cases of metastases to the pancreas, highlighting the importance of clinical data, imaging features and the use of immunocytochemistry to lead the diagnosis. We retrospectively searched our archives for metastatic neoplasm to the pancreas diagnosed with FNA performed with endoscopic ultrasound, over a 5-year period. Furthermore, we reviewed the literature for imaging and cytologic features. We described five cases of metastatic neoplasms, a renal cell carcinoma, a breast carcinoma, one leiomyosarcoma, a hepatocellular carcinoma, and ovarian serous carcinoma. All of them has history of primary malignancy and were confirmed with immunostains. All the patients were asymptomatic and identified the metastasis during the follow-up, except for the ovarian serous carcinoma were the patient had acute abdominal pain, and the most common imaging feature were the irregular borders. Although the metastases to pancreas are rare, its important to always have the history of the patient, imaging features, and the suspicion at the moment of the evaluation of the smears and cell-block, because the management and prognostic its different compared to primary malignancies.

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“…However, it is not uncommon to see the conversion of hormone receptors from the primary sites (up to 36%) and the diagnosis cannot be ruled out by negative staining. 20 , 21 , 22 Based on our search of literature in PubMed 13 , 23 , 24 , 25 , 26 , 27 , 28 , 29 and the literature review performed by Apodaca‐RuedaI et al in 2019 11 on the topic of pancreatic metastases from breast cancer, there are total 51 reported cases including our four cases of metastatic breast carcinomas to the pancreas, with 22 lobular and 29 ductal carcinomas. Among these 51 cases, 30 cases including current 4 cases have reported biomarkers.…”

Section: Discussionmentioning

confidence: 99%

Fine needle aspiration of pancreatic lesions focusing on secondary tumors with emphasis of metastatic breast cancer: A clinicopathological study with follow‐up

Chen

Zarrin-Khameh

2022

Cancer Medicine

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Background:The data on metastatic tumors to the pancreas diagnosed by fine needle aspiration (FNA) biopsy is limited. We report our experience of FNA of primary and secondary pancreatic tumors emphasizing metastatic breast cancer in the pancreas.Method: Total 274 cases of pancreatic FNA in 10 years were retrospectively reviewed. Literature review of metastatic breast cancers to the pancreas was performed.Results: Out of the 274 cases, 7 (7/274, 2.6%) cases were non-diagnostic, 46 (46/274, 16.8%) cases were negative for malignancy, and 40 (40/274, 14.6%) cases were under the category of atypical cells. There were 133 (133/274, 48.5%) cases diagnosed as positive for malignancy, 20 (20/274, 7.3%) suspicious for malignancy, and 28 (28/274, 10.2%) cases in the category of neoplastic: other. The most common neoplasm diagnosed was ductal adenocarcinoma (114/274, 41.6%; 114/133, 85.7% in positive for malignancy category). Ten cases (10/274, 3.7%) were diagnosed as metastatic neoplasms to the pancreas, including four breast infiltrating ductal carcinomas (IDC), one endocervical adenocarcinoma, one anal/ rectal squamous cell carcinoma, one renal cell carcinoma, one hepatocellular carcinoma, one seminoma and one lung adenocarcinoma. We summarized the biomarkers of the four metastatic breast cancers and conducted literature review on biomarkers of metastatic breast cancers to the pancreas. Conclusions:Upon analyzing FNAs of primary and secondary tumors in the pancreas, we have found breast carcinoma is the most common secondary pancreatic neoplasm in our patient population. Triple negative breast ductal carcinoma is the most common tumor among the metastasis of breast carcinomas to the pancreas. To the best of our knowledge, this study is the first report with a literature review focusing on biomarkers of metastatic breast cancer to the pancreas.

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EUS-FNA Diagnosis with Core Biopsy of Pancreatic Metastases from Primary Breast Cancer

Cited by 5 publications

References 8 publications

A Rare Case of Duodenal Metastasis from Lobular Breast Cancer: From Diagnosis to Surgery

A Rare Case of Duodenal Metastasis from Lobular Breast Cancer: From Diagnosis to Surgery

Metastases to pancreas diagnosed by endoscopic ultrasound-guided fine-needle aspiration: A case series and review of imaging and cytologic features

Fine needle aspiration of pancreatic lesions focusing on secondary tumors with emphasis of metastatic breast cancer: A clinicopathological study with follow‐up

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