Role of Endoscopic Ultrasound and Endoscopic Ultrasound-Guided Fine-Needle Aspiration in Diagnosing Metastasis to the Pancreas: A Tertiary Center Experience

Pancreatic involvement by metastasizing neoplasms as determined by endoscopic ultrasound‐guided fine needle aspiration: A clinicopathologic characterization

“…In our patient cohort we observed that the mean interval from diagnosis of the primary neoplasm to metastatic involvement of the pancreas was 58.7 months, however when we segregated the cases into RCC (100.2 months) and all other neoplasms (31.0 months), RCC had a significantly longer interval period to metastasis to the pancreas. 10,28,30 The mean survival from the time of diagnosis of metastatic involvement of the pancreas was 43.7 months for all cases in our study, however a significantly longer survival was observed in patients with RCC (88.9 months) as opposed to all other neoplasms (10.1 months). 6,16,18-23,25,28,31 Alomari et al described that the mean interval period specifically for RCC was 141.6 months.…”

“…In our patient cohort we noted that the head and body were the most common sites of involvement, with other studies also describing the head and body as frequent sites of involvement. 6,13,22,28,30 It is not clear as to why the size of individual metastatic lesions appear smaller in our series, though the interval of clinical follow-up may be a factor. 6,13,22,28,30 It is not clear as to why the size of individual metastatic lesions appear smaller in our series, though the interval of clinical follow-up may be a factor.…”

How good is fine needle aspiration? What results should you expect?

“…[25] Reports dealing with the FNA diagnostic yield are limited but on a small series, the EUS-FNA sampling adequacy seems to be similar compared to primitive tumors of the pancreas. [27]…”

Pancreatic Metastasis from Rectal Cancer that was Diagnosed by Endoscopic Ultrasonography-guided Fine Needle Aspiration (EUS-FNA)

“…In the present case, CT showed a hypodense mass with delayed enhancement, similarly to primary pancreatic cancer, and no dilatation of the distal main pancreatic duct due to the location of the mass in the pancreatic tail. On the other hand, the EUS findings of pancreatic metastases occasionally differ from those of primary pancreatic cancer (21,22). Hijioka et al (22) reported that the presence of a regular lesion border, together with the absence of a retention cyst and main pancreatic duct dilation in an EUS examination were indicative of pancreatic metastasis rather than primary pancreatic cancer.…”

“…On the other hand, the EUS findings of pancreatic metastases occasionally differ from those of primary pancreatic cancer (21,22). Hijioka et al (22) reported that the presence of a regular lesion border, together with the absence of a retention cyst and main pancreatic duct dilation in an EUS examination were indicative of pancreatic metastasis rather than primary pancreatic cancer. However, their study only included 1 case of pancreatic metastasis from colon cancer; thus, these EUS findings may not apply to metastasis from colorectal cancer.…”