Elsevier

Seminars in Oncology

Volume 35, Issue 2, April 2008, Pages 160-171
Seminars in Oncology

Surgery for metastatic cancer
Metastatic Disease to the Pancreas and Spleen

https://doi.org/10.1053/j.seminoncol.2007.12.008Get rights and content

Isolated metastases to the pancreas and spleen are a rare occurrence. When they are diagnosed, pancreatic metastases are most often from renal cell carcinoma, lung cancer, and breast cancer. The most common source of splenic metastases is gynecological in origin; the overwhelming majority is ovarian. If extensive staging studies reveal these metastases to be isolated, then curative resection may be warranted. This review will demonstrate that long-term survival may be achieved in patients with isolated metastases and a prolonged disease-free interval.

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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