Surgery for metastatic cancerMetastatic Disease to the Pancreas and Spleen
Section snippets
Metastatic Disease to the Pancreas
The pancreas is a site of metastatic spread from a multitude of different primary neoplasms. One example is illustrated in Figure 1. Autopsy data show that 3% to 12% of all patients with diffuse metastatic disease have pancreatic involvement.1, 2, 3, 4, 5 In a review of 4,955 autopsies, Adsay et al found that 81 patients had metastatic disease with spread to the pancreas. This study demonstrated that the most common primary malignancies that metastasize to the pancreas include lung, stomach,
Metastatic Disease to the Spleen
The spleen is a relatively frequent site of metastasis in disseminated cancer.76 Berge et al found the spleen to be the tenth most common site of metastasis, with an incidence of neoplastic involvement in 7.1% of autopsy cases of cancer patients.77 Although splenic involvement is seen fairly often, isolated metastases to the spleen are exceedingly rare. In 2001, Agha-Mohammadi et al reported a series of 54 patients, and found the most common primary neoplasms to be gynecologic (61%), colorectal
Conclusion
Isolated metastases to pancreas and spleen occur rarely. Most often these metastases are associated with disseminated disease. The most common primaries with isolated pancreatic metastases include renal cell carcinoma, lung cancer, and breast cancer. On the other hand, the most common primaries associated with splenic metastases are gynecologic—primarily ovarian. Review of the literature shows that in appropriate patients with isolated metastases and prolonged disease-free interval, long-term
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Cited by (46)
Efficacy and safety of CT-guided high-dose-rate interstitial brachytherapy in primary and secondary malignancies of the pancreas
2019, European Journal of RadiologyCitation Excerpt :However, despite many therapeutic developments only moderate achievements regarding outcome and survival have been made over the last decades and especially in patients with locally advanced/unresectable or recurrent disease treatment options are scarce [11–13]. Apart from numerous studies considering therapy of PDAC little data exists regarding secondary malignancies of the pancreas; the estimated incidence of clinical occurrence of isolated metastatic lesions (ML) to the pancreas is about 2–5 % of all pancreatic neoplasm and in the majority of cases the represented primary tumor are renal, lung, colorectal or breast cancer and sarcoma [14,15]. Therapeutic options including resection depend on the type of primary tumor, location and number/volume of metastatic lesions and the patient’s performance status.
Imaging features of pancreatic metastases: A comparison with pancreatic ductal adenocarcinoma
2018, Clinical ImagingCitation Excerpt :In our study, the most frequent primary malignancies that metastasized to the pancreas were lung cancer and renal cell carcinoma, in line with previous studies [20]. PM may be recognized during the initial imaging staging, at routine follow-up or when imaging is performed for specific signs or symptoms, such as jaundice or abdominal pain [20,21]. PM are commonly associated with disseminated disease and poor prognosis; indeed, a median survival of 8.7 months has been reported in the literature [22].
Robotic stereotactic treatment for malignant metastasis of solid tumour in the pancreas: A multiple case report and review of literature
2017, Cancer/RadiotherapieCitation Excerpt :The most represented primary tumours are renal, colorectal, breast, lung cancer, and sarcoma [4]. Due to their rarity, metastasis to the pancreas can be misdiagnosed for primary tumours and are usually found (in two third of cases) as metachronous lesion in patients undergoing follow-up or active treatment for metastatic tumours [4]. Metastasectomy is a known therapeutic strategy in case of lung and liver metastasis, and a resection of these lung and liver metastasis demonstrated an outcome benefit [5–7].
Ecology of the Metastatic Process
2017, Ecology and Evolution of CancerChapter 64 - Pancreas as a site of metastatic cancer
2016, Blumgart's Surgery of the Liver, Biliary Tract and Pancreas: Sixth EditionSplenic metastasis from gastric adenocarcinoma: A rare case
2015, International Journal of Surgery Case Reports
Supported in part by the Thomas Jefferson Surgical Pancreatic Research Fund.