Detection of pancreatic metastases by EUS-guided fine-needle aspiration

Annette Fritscher-Ravens, Parupudi V.J. Sriram, Christina Krause, Ziya Atay, Stefan Jaeckle, Frank Thonke, Boris Brand, Sabine Bohnacker, Nib Soehendra

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Abstract

Background: Metastases to the pancreas are usually found incidentally. Tissue diagnosis is imperative because imaging alone is incapable of differentiating them from primary pancreatic tumors. This study tested whether it is possible to differentiate metastases from other focal pancreatic lesions by using EUS-guided fine-needle aspiration (EUS-FNA) for cytodiagnosis. Methods: One hundred fourteen consecutive patients (mean age 61 years) with focal pancreatic masses, detected on CT, underwent EUS-FNA by using a linear-array echoendoscope and 22-gauge needles. Results: Adequate specimens were obtained from 112 lesions. Carcinomas were identified in 68 cases (60.7%), 56 (50%) of pancreatic origin and 12 (10.7%) from distant primary tumors. The metastases were all located in the head and body of the pancreas and measured 1.8 to 4.0 cm. The echotexture was heterogeneous or hypoechoic in all cases and resembled that of primary tumors. Six of the 12 patients with metastatic disease had a prior diagnosis of cancer (breast, 3; renal cell, 2; salivary gland, 1), 4 of them with a recurrence and 2 with a second carcinoma metastasizing to the pancreas. Six patients without a prior diagnosis of cancer had metastases from renal cell, colonic, ovarian, and esophageal carcinomas; one metastasis was from an unknown primary and another was from a malignant lymphoma. These findings influenced the therapeutic strategy in 8 patients who underwent nonsurgical palliatlon. There were no complications. Conclusions: Pancreatic metastasis is an important cause of focal pancreatic lesions, but the EUS features are not diagnostic. Simultaneous EUS-FNA allows cytodiagnosis and can have a decisive influence on the selection of appropriate therapeutic strategies.

Original languageEnglish (US)
Pages (from-to)65-70
Number of pages6
JournalGastrointestinal endoscopy
Volume53
Issue number1
DOIs
StatePublished - Jan 1 2001

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ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

Fritscher-Ravens, A., Sriram, P. V. J., Krause, C., Atay, Z., Jaeckle, S., Thonke, F., Brand, B., Bohnacker, S., & Soehendra, N. (2001). Detection of pancreatic metastases by EUS-guided fine-needle aspiration. Gastrointestinal endoscopy, 53(1), 65-70. https://doi.org/10.1067/mge.2001.111771