nach oben

Virchows Archiv

Erschienen in:

01.06.2004 | Original Article

Secondary tumors of the pancreas: an analysis of a surgical and autopsy database and review of the literature

verfasst von: N. Volkan Adsay, Aleodor Andea, Olca Basturk, Nihal Kilinc, Hind Nassar, Jeanette D. Cheng

Erschienen in: Virchows Archiv | Ausgabe 6/2004

Einloggen, um Zugang zu erhalten

Abstract

The vast majority of pancreatic carcinomas are primary, and, among these, more than 90% are of ductal origin. However, a variety of extrapancreatic tumors may involve the pancreas secondarily and may manifest different clinicopathological characteristics and outcomes. In this study, pathology material from 973 surgical specimens and 4955 adult autopsy cases was reviewed to identify the tumors metastatic to or secondarily involving the pancreas. Biliary and periampullary neoplasms and tumors confined to peripancreatic soft tissue were excluded. In the autopsy series, the pancreas was involved by tumor in 190 cases, and 81 of these were secondary tumors. These were predominantly of epithelial origin, most commonly from lung (34), followed by GI tract (20), kidney (4), breast (3), liver (2), ovary (1), and urinary bladder (1). In addition, there were six tumors of hematopoietic origin, two melanomas, two sarcomas, and two mesotheliomas. Among the 973 surgical specimens, 38 cases contained metastatic tumors to the pancreas. Of these, 11 were lymphomas, and the others were carcinomas of stomach (7), kidney (6), lung (2), liver, prostate, ovary, uterus (1 case of each), and a Merkel cell carcinoma. In addition, there were three malignant gastrointestinal stromal tumors and one retroperitoneal leiomyosarcoma. In conclusion, lung cancer is the most common source of metastasis to pancreas, followed by gastrointestinal carcinomas and lymphomas. These tumors are usually seen in patients with disseminated disease and are detected mainly in autopsies. Secondary tumors constitute about 4% of pancreatic specimens in the authors’ surgical database. Approximately one-third of them are clinically mistaken as primary tumors of the pancreas. These are predominantly hematopoietic malignancies or carcinomas of renal or gastric origin. Secondary tumors should be entertained in both the clinical and pathological differential diagnosis of pancreatic neoplasia.

Abbas MA, Collins JM, Mulligan DC (2001) Renal cell carcinoma metastatic to pancreas. Am J Surg 182:183–184CrossRefPubMed

Alcala Pedrajas JN, Jimenez Murillo L, Clemente Millan MJ (1996) Retroperitoneal liposarcoma with lung, skin and pancreatic metastases. Arch Bronconeumol 32:313–315PubMed

Audisio RA, La Monica G (1985) Solitary pancreatic metastasis occurring 20 years after nephrectomy for carcinoma of the kidney. Tumori 71:197–200PubMed

Avisse C, Flament JB, Deville J et al (1994) Late and multiple endocrine metastases of an adenocarcinoma of the kidney. Chirurgie 120:50–53PubMed

Azzarelli A, Clemente C, Quagliuolo V et al (1982) A case of pancreatoduodenectomy as resolutive treatment for a solitary metastasis of breast cancer. Tumori 68:331–335PubMed

Bachmeyer C, Alovor G, Chatelain D et al (2002) Cystic metastasis of the pancreas indicating relapse of Merkel cell carcinoma. Pancreas 24:103–105CrossRefPubMed

Barras JP, Baer H, Stenzl A et al (1996) Isolated late metastasis of a renal cell cancer treated by radical distal pancreatectomy. HPB Surg 10:51–54PubMed

Behrns KE, Sarr MG, Strickler JG (1994) Pancreatic lymphoma: is it a surgical disease? Pancreas 9:662–667PubMed

Bell HG, David R, Shamsuddin AM (1982) Extrahepatic biliary obstruction and liver failure secondary to myeloma of the pancreas. Hum Pathol 13:940–942PubMed

10.

Biset JM, Laurent F, de Verbizier G et al (1991) Ultrasound and computed tomographic findings in pancreatic metastases. Eur J Radiol 12:41–44PubMed

11.

Boudghene FP, Deslandes PM, LeBlanche AF et al (1994) US and CT imaging features of intrapancreatic metastases. J Comput Assist Tomogr 18:905–910

12.

Brodish RJ, McFadden DW (1993) The pancreas as the solitary site of metastasis from melanoma. Pancreas 8:276–278PubMed

13.

Butturini G, Bassi C, Falconi M et al (1998) Surgical treatment of pancreatic metastases from renal cell carcinomas. Dig Surg 15:241–246CrossRefPubMed

14.

Calmes JM, Meyer A (1993) Pancreatic hypernephroma manifested by a duodenal hemorrhage. Rev Med Suisse Romande 113:629–631PubMed

15.

Carini M, Selli C, Barbanti G et al (1988) Pancreatic late recurrence of bilateral renal cell carcinoma after conservative surgery. Eur Urol 14:258–260PubMed

16.

Charnsangavej C, Whitley NO (1993) Metastases to the pancreas and peripancreatic lymph nodes from carcinoma of the right side of the colon: CT findings in 12 patients. Am J Roentgenol 160:49–52

17.

Cubilla LA, Fitzgerald PJ (1984) Tumors of the exocrine pancreas, 19th volume, 2nd edn. Armed Forces Institute Pathology, Washington, DC

18.

Derias NW, Chong WH (1993) Fine needle aspiration diagnosis of a late solitary pancreatic metastasis of renal adenocarcinoma. Cytopathology 4:369–372PubMed

19.

Diaz Dominguez J, Rodriguez Alvarez de la Marina J, Galindo Garcia A et al (1993) Solitary metachronous pancreatic metastasis of renal adenocarcinoma. Rev Esp Enferm Dig 83:467–469PubMed

20.

Diederich S, Wernecke K, Lohnert J et al (1993) Pancreatic metastases: sonographic and computed tomographic findings. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 158:325–331PubMed

21.

Dousset B, Andant C, Guimbaud R et al (1995) Late pancreatic metastasis from renal cell carcinoma diagnosed by endoscopic ultrasonography. Surgery 117:591–594PubMed

22.

Fabre JM, Rouanet P, Dagues F et al (1995) Various features and surgical approach of solitary pancreatic metastasis from renal cell carcinoma. Eur J Surg Oncol 21:683–686PubMed

23.

Franciosi RA, Russo JF (1969) Renal cell carcinoma metastatic to the pancreas thirteen years following nephrectomy. Mil Med 134:200–203PubMed

24.

Fritscher-Ravens A, Sriram PV, Krause C et al (2001) Detection of pancreatic metastases by EUS-guided fine-needle aspiration. Gastrointest Endosc 53:65–70CrossRefPubMed

25.

Germain M, Strich M, Chaput JC et al (1976) Obstructive jaundice caused by pancreatic metastasis from an ocular nevocarcinoma operated on 30 years previously. Arch Fr Mal App Dig 65:307–311PubMed

26.

Ghavamian R, Klein KA, Stephens DH et al (2000) Renal cell carcinoma metastatic to the pancreas: clinical and radiological features. Mayo Clin Proc 75:581–585PubMed

27.

Glass RJ, Eftekhari F, Kleinerman ES et al (1996) Osteosarcoma metastatic to the pancreas in young patients. Clin Radiol 51:293–294PubMed

28.

Gohji K, Matsumoto O, Kamidono S (1990) Solitary pancreatic metastasis from renal cell carcinoma. Hinyokika Kiyo—Acta Urol Jpn 36:677–681

29.

Gutman M, Inbar M, Klausner JM (1993) Metastases-induced acute pancreatitis: a rare presentation of cancer. Eur J Surg Oncol 19:302–304PubMed

30.

Guttman FM, Ross M, Lachance C (1972) Pancreatic metastasis of renal cell carcinoma treated by total pancreatectomy. Archiv Surg 105:782–784

31.

Hermanutz KD, Sonnenberg GE (1977) Late metastasis of a hypernephroid kidney carcinoma to the pancreas with tumor invasion to the duodenum. ROFO Fortschr Geb Rontgenstr Nuklearmed 127:595–597PubMed

32.

Hiotis SP, Klimstra DS, Conlon KC et al (2002) Results after pancreatic resection for metastatic lesions. Ann Surg Oncol 9:675–679CrossRefPubMed

33.

Hirata S, Yamaguchi K, Bandai S et al (2002) secondary extramedullary plasmacytoma involving the pancreas. J Hepatobiliary Pancreat Surg 9:111–115CrossRefPubMed

34.

Jenssen E (1952) A metastatic hypernephroma to the pancreas. Acta Chir Scand 104:177–180PubMed

35.

Jobran R, Baloch ZW, Aviles V et al (2000) Tall cell papillary carcinoma of the thyroid: metastatic to the pancreas. Thyroid 10:185–187PubMed

36.

Johansson H, Krause U, Olding L (1970) pancreatic metastases from a malignant melanoma. Scand J Gastroenterol 5:573–575PubMed

37.

Johnson DH, Hainsworth JD, Greco FA (1985) Extrahepatic biliary obstruction caused by small-cell lung cancer. Ann Int Med 102:487–490PubMed

38.

Kishimoto H, Nimura Y, Okamoto K et al (1985) A case of resected renal cell carcinoma with massive pancreatic metastases. Gan No Rinsho—Jpn J Cancer Clin 31:91–96

39.

Klein KA, Stephens DH, Welch TJ (1998) CT characteristics of metastatic disease of the pancreas. Radiographics 18:369–378PubMed

40.

Klöppel G, Heitz PU (1984) Pancreatic pathology. Churchill Livingstone, Edinburgh, p 108

41.

Komoda H, Nishida T, Yumiba T et al (2002) Primary leiomyosarcoma of the pancreas—a case report and case review. Virchows Arch 440:334–337PubMed

42.

Koniaris LG, Lillemoe KD, Yeo CJ et al (2000) Is there a role for surgical resection in the treatment of early-stage pancreatic lymphoma? J Am Coll Surg 190:319–330CrossRefPubMed

43.

Krouwer HG, Vollmerhausen J, White J et al (1991) Desmoplastic medulloblastoma metastatic to the pancreas: case report. Neurosurgery 29:612–616PubMed

44.

Ladouch A, Fabre M, Vieillefond A et al (1975) Malignant melanoma occurring on a dermoid cyst of the ovary. Pancreatic metastasis. Arch Anat Pathol 23:217–220

45.

Lankisch PG, Lohr A, Kunze E (1987) Acute metastasis-induced pancreatitis in bronchial carcinoma. Dtsch Med Wochenschr 112:1335–1337PubMed

46.

Le Borgne J, Partensky C, Glemain P et al (2000) Pancreaticoduodenectomy for metastatic ampullary and pancreatic tumors. Hepatogastroenterology 47:540–544PubMed

47.

Lee JS, Kim HS, Jung JJ et al (2001) Ancient schwannoma of the pancreas mimicking a cystic tumor. Virchows Arch 439:697–699PubMed

48.

Leger L, Bondel P, Charpentier Y et al (1974) Secondary cancer of the pancreas of cystic form. J Chir (Paris) 108:195–202

49.

Levine M, Danovitch SH (1973) Metastatic carcinoma to the pancreas. Another cause for acute pancreatitis. Am J Gastroenterol 60:290–294PubMed

50.

Lüttges J, Mentzel T, Hubner G et al (1999) Solitary fibrous tumour of the pancreas: a new member of the small group of mesenchymal pancreatic tumours. Virchows Arch 435:37–42PubMed

51.

Marcote Valdivieso E, Arlandis Felix F, Baltasar A et al (1993) Synchronous pancreatic metastasis of renal carcinoma. Rev Esp Enferm Dig 83:471–473PubMed

52.

Marquand J, Giraud B, Maliakas S (1971) Pancreatic metastasis revealing a kidney neoplasm. J Urol Nephrol 77:595–601

53.

Matsukuma S, Suda K, Abe H et al (1997) Metastatic cancer involving pancreatic duct epithelium and its mimicry of primary pancreatic cancer. Histopathology 30:208–213CrossRefPubMed

54.

McLatchie GR, Imrie CW (1981) Acute pancreatitis associated with tumour metastases in the pancreas. Digestion 21:13–17PubMed

55.

Mehta SA, Jagannath P, Krishnamurthy SC et al (1991) Isolated pancreatic metastasis from locally controlled breast cancer: a case report. Indian J Cancer 28:48–50PubMed

56.

Melo CR, Melo IS, Monteiro AZ et al (1992) Pancreatic metastasis from renal cell carcinoma. Arq Gastroenterol 29:110–112PubMed

57.

Merkle EM, Bender GN, Brambs HJ (2000) Imaging findings in pancreatic lymphoma: differential aspects. AJR Am J Roentgenol 174:671–675PubMed

58.

Mikhail MG, Lim KB (1989) Dedifferentiated chondrosarcoma metastasizing to the pancreas in pregnancy. Acta Obstet Gynecol Scand 68:467–468PubMed

59.

Mossner J, Wagner T, Wunsch PH et al (1982) Differential diagnosis of pancreatitis: metastasis to the pancreas. Leber Magen Darm 12:165–170PubMed

60.

Mountney J, Maury AC, Jackson AM et al (1997) Pancreatic metastases from breast cancer: an unusual cause of biliary obstruction. Eur J Surg Oncol 23:574–576PubMed

61.

Mulligan ME, Fellows DW, Mullen SE (1997) Pancreatic metastasis from Ewing’s sarcoma. Clin Imaging 21:23–26CrossRefPubMed

62.

Muranaka T, Teshima K, Honda H et al (1989) Computed tomography and histologic appearance of pancreatic metastases from distant sources. Acta Radiol 30:615–619PubMed

63.

Nakamura E, Shimizu M, Itoh T et al (2001) Secondary tumors of the pancreas: clinicopathological study of 103 autopsy cases of Japanese patients. Pathol Int 51:686–690CrossRefPubMed

64.

Nishida O, Matsunaga Y, Dekigai H et al (1991) Three elderly cases of renal cell carcinoma with pancreatic metastasis. Nippon Ronen Igakki Zasshi—Jpn J Geriatr 28:392–396

65.

Onishi T, Ohishi Y, Iizuka N et al (1995) Clinical characteristics of 7 renal cell carcinoma patients developing a solitary pancreatic metastasis after nephrectomy. Nippon Hinyokika Gakkai Zasshi—Jpn J Urol 86:1538–1542

66.

Opocher E, Galeotti F, Spina GP et al (1982) Diagnosis of secondary tumors of the pancreas. Analysis of 13 cases. Minerva Medica 73:577–581PubMed

67.

Palazzo L, Borotto E, Cellier C et al (1996) Endosonographic features of pancreatic metastases. Gastrointest Endosc 44:433–436PubMed

68.

Pappo I, Feigin E, Uziely B et al (1991) Biliary and pancreatic metastases of breast carcinoma: is surgical palliation indicated? J Surg Oncol 46:211–214PubMed

69.

Paz A, Koren R, Gal R et al (1996) Late solitary pancreatic metastasis from renal cell carcinoma. Isr J Med Sci 32:1319–1321PubMed

70.

Piccinini EE, Ugolini G, Rosati G et al (1996) Solitary pancreatic metastasis of renal cell cancer treated by pancreaticoduodenectomy: a case report. Cancer Control 3:466–468PubMed

71.

Pietsch JB, Shankar S, Ford C et al (2001) Obstructive jaundice secondary to lymphoma in childhood. J Pediatr Surg 36:1792–1795CrossRefPubMed

72.

Reale D, Squillaci S, Guarino M et al (1993) Late pancreatic metastasis of renal carcinoma. Description of 2 cases and review of the literature. Minerva Urol Nefrol 45:183–186PubMed

73.

Reinhard H, Hill K (1977) Tryptic pancreatitis in small-cell bronchial carcinoma (Author’s Translation). Dtsch Med Wochensch 102:797–799

74.

Robbins EG II, Franceschi D, Barkin JS (1996) Solitary metastatic tumors to the pancreas: a case report and review of the literature. Am J Gastroenterol 91:2414–2417PubMed

75.

Roland CF, van Heerden JA (1989) Nonpancreatic primary tumors with metastasis to the pancreas. Surg Gynecol Obstet 168:345–347PubMed

76.

Rubin E, Dunham WK, Stanley RJ (1985) Pancreatic metastases in bone sarcomas: CT demonstration. J Comput Assist Tomogr 9:886–888

77.

Rumancik WM, Megibow AJ, Bosniak MA et al (1984) Metastatic disease to the pancreas: evaluation by computed tomography. J Comput Assist Tomogr 8:829–834

78.

Safadi R, Pappo O, Okon E et al (1996) Merkel cell tumor in a woman with chronic lymphocytic leukemia. Leuk Lymphoma 20:509–511PubMed

79.

Saitoh H, Hida M, Wakabayashi T et al (1982) Metastasis of urothelial tumors of the bladder: correlation between sites and number of organs involved. Tokai J Exp Clin Med 7:517–526PubMed

80.

Sauvanet A, Barthes T, Levy P et al (1993) Late pancreatic metastasis from renal cell carcinoma [Letter]. Pancreas 8:742–744

81.

Schumacher A (1993) Delayed diagnosis of ovarian cancer with metastasis to the pancreas. Zentralbl Gynakol 115:568–569PubMed

82.

Shinagawa Y, Suzuki T, Hamanaka Y et al (1992) Solitary pancreatic metastasis of malignant fibrous histiocytoma treated by distal pancreatectomy. Pancreas 7:726–730PubMed

83.

Simpson NS, Mulholland CK, Lioe TF et al (1989) Late, solitary metastatic renal carcinoma in the pancreas. Ulster Med J 58:198–199PubMed

84.

Skaarup P, Jorgensen T, Larsen S (1984) Asynchronous metastasizing renal cell carcinoma associated with progressive immune complex glomerulonephritis and proteinuria. Scand J Urol Nephrol 18:351–356PubMed

85.

Sohn TA, Yeo CJ, Cameron JL et al (2001) Renal cell carcinoma metastatic to the pancreas: results of surgical management. J Gastrointest Surg 5:346–351CrossRefPubMed

86.

Stankard CE, Karl RC (1992) The treatment of isolated pancreatic metastases from renal cell carcinoma: a surgical review. Am J Gastroenterol 87:1658–1660PubMed

87.

Sugimura H, Tamura S, Kodama T et al (1991) Metastatic pancreas cancer from the thyroid: clinical imaging mimicking non-functioning islet cell tumor. Radiat Med 9:167–169PubMed

88.

Tanabe S, Soeda S, Mukai T et al (1984) A case report of pancreatic metastasis of an intracranial angioblastic meningioma (hemangiopericytoma) and a review of metastatic tumor to the pancreas. J Surg Oncol 26:63–68PubMed

89.

Taziaux P, Dallemagne B, Delforge M et al (1994) An unusual case of clear-cell carcinoma of the pancreas. J Chir 131:86–89

90.

Temellini F, Bavosi M, Lamarra M et al (1989) Pancreatic metastasis 25 years after nephrectomy for renal cancer. Tumori 75:503–504PubMed

91.

Thompson LD, Heffess CS (2000) Renal cell carcinoma to the pancreas in surgical pathology material. Cancer 89:1076–1088CrossRefPubMed

92.

Ueda K, Nagayama Y, Narita K et al (2000) Pancreatic involvement by non-Hodgkin’s lymphoma. J Hepatobiliary Pancreat Surg 7:610–613CrossRefPubMed

93.

Viliavin GD, Sarkisov DS, Daurova TT (1965) Metastasis from an ovarian cilioepithelial cyst to the pancreas (a case). Vopr Onkol 11:88–89

94.

Wastell C (1966) A solitary secondary deposit in the pancreas from a carcinoma of the cervix. Postgrad Med J 42:59–61PubMed

95.

Weerdenburg JP, Jurgens PJ (1984) Late metastases of a hypernephroma to the thyroid and the pancreas. Diagn Imaging Clin Med 53:269–272PubMed

96.

Wernecke K, Peters PE, Galanski M (1986) Pancreatic metastases: US evaluation. Radiology 160:399–402PubMed

97.

Willis RA (1973) The spread of tumors in the human body, 3rd edn. Butterworths, London, pp 216–217

98.

Wolfson P, Rybak BJ, Kim U (1978) Cystosarcoma phyllodes metastatic to the pancreas. Am J Gastroenterol 70:184–187PubMed

99.

Z’Graggen K, Fernandez-del Castillo C, Rattner DW et al (1998) Metastases to the pancreas and their surgical extirpation. Arch Surg 133:413–419CrossRefPubMed

100.

Zhao B, Kimura W, Futakawa N et al (1997) Renal cell carcinoma of the spindle cell type with metastasis to the pancreas: a case report. Jpn J Clin Oncol 27:58–61CrossRefPubMed

Titel: Secondary tumors of the pancreas: an analysis of a surgical and autopsy database and review of the literature
verfasst von: N. Volkan Adsay
Aleodor Andea
Olca Basturk
Nihal Kilinc
Hind Nassar
Jeanette D. Cheng
Publikationsdatum: 01.06.2004
Verlag: Springer-Verlag
Erschienen in: Virchows Archiv / Ausgabe 6/2004
Print ISSN: 0945-6317
Elektronische ISSN: 1432-2307
DOI: https://doi.org/10.1007/s00428-004-0987-3

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Secondary tumors of the pancreas: an analysis of a surgical and autopsy database and review of the literature

Abstract

Neu im Fachgebiet Pathologie

Molekularpathologische Untersuchungen im Wandel der Zeit

Vergleichende Pathologie in der onkologischen Forschung

Gastrointestinale Stromatumoren

Personalisierte Medizin in der Onkologie

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 6/2004

Gastrointestinal stromal tumor: report of two unusual cases

Endometrioid carcinoma of the urinary bladder complicating vesical Mullerianosis: a case report and review of the literature

Electron microscopy and immunohistochemistry studies of pulmonary carcinosarcomas expressing the transcription factor MEF-2 and showing significant cell-to-cell, cell-to-matrix, and epithelial–mesenchymal interactions

Reduction of PTEN and p27kip1 expression correlates with tumor grade in prostate cancer. Analysis in radical prostatectomy specimens and needle biopsies

Transforming growth factor β1-induced glomerulopathy is prevented by 17β-estradiol supplementation

June 2004

Neu im Fachgebiet Pathologie

Molekularpathologische Untersuchungen im Wandel der Zeit

Vergleichende Pathologie in der onkologischen Forschung

Gastrointestinale Stromatumoren

Personalisierte Medizin in der Onkologie