One case of pancreatic metastases from small cell lung cancer / 中华内分泌外科杂志

Pancreatic metastasis of small cell lung cancer is very rare in clinic. The purpose of this article is to improve the knowledge of clinical and radiologists about this disease by reporting one case.

Pancreatitis aguda como primera manifestación de un carcinoma microcítico de pulmón / Metastasis-induced aAcute pancreatitis as the initial presentation of a small cell lung carcinoma

Las metástasis de cualquier origen son una causa muy infrecuente de pancreatitis aguda. Se presenta el caso de una paciente con un episodio de pancreatitis aguda como manifestación inicial de un carcinoma microcítico de pulmón metastásico. Es importante excluir la presencia de tumores malignos en aquellos casos de pancreatitis aguda sin agente etiológico claro para mejorar el pronóstico de estos pacientes. Se revisó la literatura al respecto.

Metastases of different any origin that induceare a rare cause of acute pancreatitis are not frequent. We report the case 5 of a patient with an acute pancreatitis episode as the initial manifestation of an extended small cell lung carcinoma. The exclusion of malignancy in cases of pancreatitis of unknown origin is clinically relevant to improve the prognosis of these patients. We review the A literature review on about this topic is also presented.

Pancreatic Metastases from Ovarian Carcinoma – Diagnosis by Endoscopic Ultrasound-Guided Fine Needle Aspiration

Pancreatic metastases are very uncommon and originate most commonly from lung, colon, breast and kidney cancer. Ovarian adenocarcinoma has been reported as a primary site of pancreatic metastasis, but its diagnosis has rarely being reported by endoscopic ultrasound guided fine needle aspiration (EUS-FNA). We report a case of multiple metastases to the pancreas from ovarian carcinoma occurring four years after original resection of the primary tumour. Our patient presented with severe epigastric pain which was initially treated as acute pancreatitis. Further imaging modalities showed multiple large pseudocystic lesions in the pancreatic head and body. Subsequent EUSFNA confirmed that the lesions were metastatic disease from an advanced ovarian carcinoma. She underwent palliative chemotherapy and the pancreatic lesion showed receding size.

Achados da tomografia computadorizada em metástases pancreáticas do carcinoma de células renais / Computed tomography findings of pancreatic metastases from renal cell carcinoma

OBJETIVO: Apresentar os achados da tomografia computadorizada observados em quatro pacientes submetidos a nefrectomia radical por carcinoma de células renais e que apresentaram metástases pancreáticas. MATERIAIS E MÉTODOS: Os quatro pacientes foram submetidos a nefrectomia radical por carcinoma de células renais, estádios T1 (n=2) e T3a (n=2). O intervalo médio entre a nefrectomia e a detecção das metástases foi de oito anos. Dois pacientes apresentaram metástase pancreática solitária (confinada ao pâncreas) e dois apresentaram metástases pancreáticas única e múltiplas, respectivamente, ambos com recorrência tumoral no rim contralateral. RESULTADOS: As metástases pancreáticas foram visualizadas, na tomografia computadorizada, como lesões hipervascularizadas, solitária (n=2), única (n=1) ou múltiplas (n=1). Foi realizada pancreatectomia parcial em dois pacientes com metástase solitária. Estes pacientes estão livres da doença quatro e dois anos após a cirurgia, respectivamente. CONCLUSÃO: Metástases pancreáticas de carcinoma de células renais são raras, podendo ocorrer muitos anos após a apresentação inicial. Metástases pancreáticas múltiplas e metástases pancreáticas associadas a recorrência tumoral no rim contralateral são incomuns. À tomografia computadorizada, as metástases pancreáticas aparecem como lesões hipervascularizadas e solitárias, simulando tumores das ilhotas celulares. O tratamento cirúrgico das lesões solitárias deve ser considerado.

OBJECTIVE: To present computed tomography findings observed in four patients submitted to radical nephrectomy for renal cell carcinoma who developed pancreatic metastases afterwards. MATERIALS AND METHODS: The four patients underwent radical nephrectomy for stage T1 (n=2) and stage T3a (n=2) renal cell carcinoma. The mean interval between nephrectomy and detection of pancreatic metastases was eight years. Two asymptomatic patients presented with solitary pancreatic metastases (confined to the pancreas). Two symptomatic patients presented with single and multiple pancreatic metastases, both with tumor recurrence in the contralateral kidney. RESULTS: Computed tomography studies demonstrated pancreatic metastases as solitary (n=2), single (n=1) or multiple (n=1) hypervascular lesions. Partial pancreatectomy was performed in two patients with solitary pancreatic metastases and both are free of disease at four and two years after surgery. CONCLUSION: Pancreatic metastases from renal cell carcinoma are rare and can occur many years after the primary tumor presentation. Multiple pancreatic metastases and pancreatic metastases associated with tumor recurrence in the contralateral kidney are uncommon. Usually, on computed tomography images pancreatic metastases are visualized as solitary hypervascular lesions, simulating islet-cell tumors. Surgical management should be considered for patients with solitary pancreatic lesions.