Tumores metastásicos en el páncreas: el rol de la ecoendoscopia con punción / Metastatic tumors in the pancreas: the role of endoscopic ultrasound-guided fine-needle aspiration

Antecedentes y objetivos: hay pocas publicaciones sobre el papel de la ecoendoscopia con punción en lesiones pancreáticas secundarias. Describimos la serie más amplia publicada hasta ahora en un país europeo. Pacientes y métodos: revisamos retrospectivamente los casos identificados en nuestra institución de 2004 a 2016. Describimos las características clínicas de los pacientes, comparando el periodo de latencia desde el diagnóstico del tumor primario hasta la detección de la metástasis pancreática y la supervivencia de los pacientes según el diagnóstico citológico. Resultados: cuarenta y cuatro pacientes fueron diagnosticados de metástasis pancreáticas mediante ecoendoscopia con punción. Se realizaron estudios citológicos auxiliares en 28 (63,6%). Los tumores primarios más comunes fueron riñón y pulmón. Treinta y cuatro pacientes (77,3%) tenían historia previa de cáncer, con un periodo de latencia desde seis meses hasta 18,8 años. Los pacientes diagnosticados de carcinoma renal primario presentaron tiempos de latencia significativamente más largos y una supervivencia más prolongada que aquellos cuyo tumor primario fue pulmonar. En 13 pacientes, la ecoendoscopia fue la única técnica que detectó la metástasis pancreática o la que mostró un mayor número de lesiones intrapancreáticas. Las lesiones detectadas solo por ecoendoscopia fueron significativamente más pequeñas que las diagnosticadas por otros métodos de imagen (11,9 +/- 4,1 mm frente a 30,7 +/- 19,8 mm, p < 0,001). Conclusiones: la ecoendoscopia con punción juega un papel crucial en el diagnóstico de metástasis pancreáticas y puede tener un impacto clínico importante. Los pacientes con carcinoma de células renales podrían beneficiarse del seguimiento a largo plazo con ecoendoscopia

Background and objectives: there are few published data on the use of EUS guided fine-needle aspiration in secondary pancreatic lesions. We describe the largest series published so far in a European country. Patients and methods: a retrospective review of the cases identified in our institution from 2004 to 2016 has been recorded. The clinical data are described, comparing the latency period from the primary tumor diagnosis to the detection of the pancreatic metastasis and the survival of patients according to the cytological diagnosis. Results: forty-four patients were diagnosed with pancreatic metastasis using EUS guided fine needle aspiration. Ancillary cytological studies were performed in 28 (63.6%). The most common primary tumor sites were kidney and lung. Thirty-four patients (77.3%) had a previous history of malignancy, with a latency period ranging from 6 months to 18.8 years. Patients diagnosed with primary renal carcinoma had a significantly longer latency period and longer survival compared to those with primary lung cancer. In 13 patients, EUS was either the only technique that detected the PM or showed a greater number of intrapancreatic lesions. These metastases were significantly smaller than those diagnosed by other imaging studies (11.9 +/- 4.1 mm vs 30.7 +/- 19.8 mm, p < 0.001). Conclusions: EUS guided fine-needle aspiration plays a crucial role in the diagnosis of pancreatic metastases and may have a major clinical impact. Patients with renal cell carcinoma could benefit from long-term follow-up with EUS

Metastatic tumors in the pancreas: the role of endoscopic ultrasound-guided fine-needle aspiration.

BACKGROUND AND OBJECTIVES: there are few published data on the use of EUS guided fine-needle aspiration in secondary pancreatic lesions. We describe the largest series published so far in a European country. PATIENTS AND METHODS: a retrospective review of the cases identified in our institution from 2004 to 2016 has been recorded. The clinical data are described, comparing the latency period from the primary tumor diagnosis to the detection of the pancreatic metastasis and the survival of patients according to the cytological diagnosis. RESULTS: forty-four patients were diagnosed with pancreatic metastasis using EUS guided fine needle aspiration. Ancillary cytological studies were performed in 28 (63.6%). The most common primary tumor sites were kidney and lung. Thirty-four patients (77.3%) had a previous history of malignancy, with a latency period ranging from 6 months to 18.8 years. Patients diagnosed with primary renal carcinoma had a significantly longer latency period and longer survival compared to those with primary lung cancer. In 13 patients, EUS was either the only technique that detected the PM or showed a greater number of intrapancreatic lesions. These metastases were significantly smaller than those diagnosed by other imaging studies (11.9 ± 4.1 mm vs 30.7 ± 19.8 mm, p < 0.001). CONCLUSIONS: EUS guided fine-needle aspiration plays a crucial role in the diagnosis of pancreatic metastases and may have a major clinical impact. Patients with renal cell carcinoma could benefit from long-term follow-up with EUS.