Year 2019 / Volume 111 / Number 5
Original
Metastatic tumors in the pancreas: the role of endoscopic ultrasound-guided fine‐needle aspiration

345-350

DOI: 10.17235/reed.2019.5914/2018

Maite Betés, Santiago González Vázquez, Alejandro Bojórquez, María Dolores Lozano, José Ignacio Echeveste, Laura García Albarrán, Miguel Muñoz Navas, Jose Carlos Súbtil,

Abstract
Background and objectives: there are few published data on the use of EUS guided fine-needle aspiration in secondary pancreatic lesions. We describe the largest series published so far in a European country. Patients and methods: a retrospective review of the cases identified in our institution from 2004 to 2016 has been recorded. The clinical data are described, comparing the latency period from the primary tumor diagnosis to the detection of the pancreatic metastasis and the survival of patients according to the cytological diagnosis. Results: forty-four patients were diagnosed with pancreatic metastasis using EUS guided fine needle aspiration. Ancillary cytological studies were performed in 28 (63.6%). The most common primary tumor sites were kidney and lung. Thirty-four patients (77.3%) had a previous history of malignancy, with a latency period ranging from 6 months to 18.8 years. Patients diagnosed with primary renal carcinoma had a significantly longer latency period and longer survival compared to those with primary lung cancer. In 13 patients, EUS was either the only technique that detected the PM or showed a greater number of intrapancreatic lesions. These metastases were significantly smaller than those diagnosed by other imaging studies (11.9 ± 4.1 mm vs 30.7 ± 19.8 mm, p < 0.001). Conclusions: EUS guided fine-needle aspiration plays a crucial role in the diagnosis of pancreatic metastases and may have a major clinical impact. Patients with renal cell carcinoma could benefit from long-term follow-up with EUS.
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References
1. Niess H, Conrad C, Kleespies A, et al. Surgery for metastasis to the pancreas: Is it safe and effective? J Surg Oncol. 2013;107:859–64.
2. Sperti C, Moletta L, Patanè G. Metastatic tumors to the pancreas: The role of surgery. World J Gastrointest Oncol. 2014;6:381-392.
3. Eloubeidi MA, Jhala D, Chhieng DC, et al. Yield of endoscopic ultrasound-guided fine-needle aspiration biopsy in patients with suspected pancreatic carcinoma: Emphasis on atypical, suspicious, and false-negative aspirates. Cancer. 2003;99:285–92.
4. Yamabe A, Irisawa A, Bhutani MS, et al. Efforts to improve the diagnostic accuracy of endoscopic ultrasound-guided fine-needle aspiration for pancreatic tumors. Endosc Ultrasound. 2016;5:225–32.
5. Pisters PWT, Evans DB. Diagnostic Accuracy of Endoscopic Ultrasound – Guided Fine-Needle Aspiration in Patients With Presumed Pancreatic Cancer. Cancer. 2003;118–28.
6. Fujimori N, Osoegawa T, Lee L, et al. Efficacy of endoscopic ultrasonography and endoscopic ultrasonography-guided fine-needle aspiration for the diagnosis and grading of pancreatic neuroendocrine tumors. Scand J Gastroenterol. 2016;51:245–52.
7. Raymond SLT, Yugawa D, Chang KHF, et al. Metastatic neoplasms to the pancreas diagnosed by fine-needle aspiration/biopsy cytology: A 15-year retrospective analysis. Diagn Cytopathol. 2017;45:771–83.
8. El Hajj II, Leblanc JK, Sherman S, et al. Endoscopic ultrasound-guided biopsy of pancreatic metastases: A large single-center experience. Pancreas. 2013;42:524–30.
9. Krishna SG, Bhattacharya A, Ross WA, et al. Pretest prediction and diagnosis of metastatic lesions to the pancreas by endoscopic ultrasound-guided fine needle aspiration. J Gastroenterol Hepatol. 2015;30:1552–60.
10. Waters L, Si Q, Caraway N, et al. Secondary tumors of the pancreas diagnosed by endoscopic ultrasound-guided fine-needle aspiration: A 10-year experience. Diagn Cytopathol. 2014;42:738–43.
11. Olson MT, Wakely PE, Ali SZ. Metastases to the pancreas diagnosed by fine-needle aspiration. Acta Cytol. 2013;57:473–80.
12. Yang L, Iwai T, Kida M, et al. Analysis of the diagnostic yield of endoscopic ultrasonography-guided fine-needle aspiration in patients with a suspected pancreatic malignancy. Rev Esp Enferm Dig. 2018; doi: 10.17235/reed.2018.5455/2017 In press.
13. Adsay NV, Andea A, Basturk O, et al. Secondary tumors of the pancreas: An analysis of a surgical and autopsy database and review of the literature. Virchows Arch. 2004;444:527–35.
14. Showalter SL, Hager E, Yeo CJ. Metastatic Disease to the Pancreas and Spleen. Semin Oncol. 2008;35:160–71.
15. Smith AL, Odronic SI, Springer BS, et al. Solid tumor metastases to the pancreas diagnosed by FNA: A single-institution experience and review of the literature. Cancer Cytopathol. 2015;123:347–55.
16. Pannala R, Hallberg-Wallace K, Smith A, et al. Endoscopic ultrasound-guided fine needle aspiration cytology of metastatic renal cell carcinoma to the pancreas: A multi-center experience. Cytojournal. 2016;13:24.
17. Volmar KE, Jones CK, Xie HB. Metastases in the pancreas from nonhematologic neoplasms: Report of 20 cases evaluated by fine-needle aspiration. Diagn Cytopathol. 2004;31:216–20.
18. Eidt S, Jergas M, Schmidt R, et al. Metastasis to the pancreas—an indication for pancreatic resection? Langenbeck’s Arch Surg. 2007;392:539–42.
19. Song S-W, Cheng J-F, Liu N, et al. Diagnosis and treatment of pancreatic metastases in 22 patients: a retrospective study. World J Surg Oncol. 2014;12:299.
20. Zianne M, Takahashi N, Tsujibata A, et al. Asymptomatic Pancreatic Metastasis from Renal Cell Carcinoma Diagnosed 21 Years after Nephrectomy. Case Rep Gastrointest Med. 2017;2017:1–6.
21. Iglesias-García J, Abdulkader I, Lariño-Noia J, et al. Evaluation of the adequacy and diagnostic accuracy of the histology samples obtained with a newly designed 19-gauge EUS histology needle. Rev Esp Enferm Dig. 2014;106:6–14.
22. Naveed M, Siddiqui A, Kowalski T, et al. A Multicenter comparative trial of a novel EUS-guided core biopsy needle (SharkCore TM ) with the 22-gauge needle in patients with solid pancreatic mass lesions. Endosc Ultrasound. 2018;7:34-40.
23. Larsen M, Fristrup C, Detlefsen S, et al. Prospective evaluation of EUS-guided fine needle biopsy in pancreatic mass lesions. Endosc Int Open. 2018 7;06:E242–8.
24. Larghi A, Vázquez-Sequeiros E, Ricci R. ¿Deberían sustituir las agujas histológicas de punción guiada por ecoendoscopia a las agujas de citología?: “Another brick in the wall?” Revista Espanola de Enfermedades Digestivas. 2014;106:1-5.
25. Gress FG, Hawes RH, Savides TJ, et al. Role of EUS in the preoperative staging of pancreatic cancer: A large single-center experience. Gastrointest Endosc. 1999;50:786–91.
26. Kala Z, Válek V, Hlavsa J, et al. The role of CT and endoscopic ultrasound in pre-operative staging of pancreatic cancer. Eur J Radiol. 2007;62:166–9.
27. Boussios S, Zerdes I, Batsi O, et al. Pancreatic resection for renal cell carcinoma metastasis: An exceptionally rare coexistence. Int J Surg Case Rep. 2016;27:198–201.
28. Zhang L, Sanagapalli S, Stoita A. Challenges in diagnosis of pancreatic cancer. World J Gastroenterol. 2018;24:2047–60.
29. Sweeney AD, Wu MF, Hilsenbeck SG, et al. Value of Pancreatic Resection for Cancer Metastatic to the Pancreas. J Surg Res. 2009;156:189–98.
30. Reddy S, Wolfgang CL. The role of surgery in the management of isolated metastases to the pancreas. Lancet Oncol. 2009;10:287–93.
31. Zerbi A, Ortolano E, Balzano G, et al. Pancreatic metastasis from renal cell carcinoma: Which patients benefit from surgical resection? Ann Surg Oncol. 2008;15:1161–8.
32. Adler H, Redmond CE, Heneghan HM, et al. Pancreatectomy for metastatic disease: A systematic review. Eur J Surg Oncol. 2014;40:379–86.
33. Chatzizacharias NA, Rosich-Medina A, Dajani K, et al. Surgical management of hepato-pancreatic metastasis from renal cell carcinoma. World J Gastrointest Oncol. 2017;9:70-77
34. Varker KA, Muscarella P, Wall K, et al. Pancreatectomy for non-pancreatic malignancies results in improved survival after R0 resection. World J Surg Oncol. 2007;5:1–6.
35. Reddy S, Edil BH, Cameron JL, et al. Pancreatic resection of isolated metastases from nonpancreatic primary cancers. Ann Surg Oncol. 2008;15:3199–206.
36. de Reijke TM, Bellmunt J, van Poppel H, et al. EORTC-GU group expert opinion on metastatic renal cell cancer. Eur J Cancer. 2009;45:765–73.
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Betés M, González Vázquez S, Bojórquez A, Lozano M, Echeveste J, García Albarrán L, et all. Metastatic tumors in the pancreas: the role of endoscopic ultrasound-guided fine‐needle aspiration. 5914/2018


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Publication history

Received: 10/09/2018

Accepted: 14/10/2018

Online First: 11/02/2019

Published: 07/05/2019

Article revision time: 33 days

Article Online First time: 154 days

Article editing time: 239 days


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