Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2009 Mar;82(1):1-6.

Skeletal metastases in pancreatic cancer: a retrospective study and review of the literature

Mitesh J Borad  1 , Hamid Saadati, Arun Lakshmipathy, Elizabeth Campbell, Patricia Hopper, Gayle Jameson, Daniel D Von Hoff, M Wasif Saif
Affiliations
Review

Skeletal metastases in pancreatic cancer: a retrospective study and review of the literature

Mitesh J Borad et al. Yale J Biol Med. 2009 Mar.

Abstract

Background: Skeletal metastases represent an underappreciated site of metastasis in patients with pancreatic cancer. Previous reports have estimated the prevalence to range from 5 percent to 20 percent. With the use of gemcitabine and novel targeted agents such as erlotinib, there has been a modest increase in survival in patients with advanced pancreatic cancer. As such, it is anticipated that previously uncommon occurrences such as skeletal metastases will become more frequent.

Patients and methods: Retrospective chart review was conducted at two academic institutions to identify pancreatic cancer patients with skeletal metastases over a two-year period.

Results: Seven patients were identified from a database of 323 patients (2.2 percent). All patients had advanced disease and had received prior systemic therapy (range: 1-4 lines, median: 2 lines). Approximately half (57.1 percent) of the patients were symptomatic from their skeletal metastases. The most common sites of skeletal metastases were vertebrae (100 percent), hips (57.1 percent), and ribs (57.1 percent). Both blastic and lytic lesions were noted, with a predominance of blastic lesions (71.4 percent). A majority of patients (71.4 percent) received bisphosphonates as part of their care.

Discussion: Skeletal metastases are an uncommon but clinically important occurrence in patients with pancreatic cancer. Clinicians caring for patients with pancreatic cancer should be alert regarding skeletal metastases, due to the morbidity it can cause for these patients (e.g., back pain, fractures, etc.).

PubMed Disclaimer

Figures

Figure 1
Figure 1
Positron Emission Tomography/Computed Tomography (PET/CT) scan of patient with metastatic pancreatic adenocarcinoma reveals multiple areas of skeletal involvement most notably left frontal calvarium, spine, ribs, bilateral humeri, and pelvis.
Figure 2
Figure 2
Extensive involvement of spine by skeletal metastases as visualized by PET/CT scan (sagittal view).
See this image and copyright information in PMC

References

    1. Wafflart E, Gibaud H, Lerat F, et al. Muscular metastases of cancer of the pancreas. J Chir. 1996;133(4):167–170. - PubMed
    1. Otegbayo JA, Oluswasola OA, Akere A, et al. Pancreatic carcinoma presenting as cutaneous nodules in a diabetic Nigerian male. West Afr J Med. 2005;24(2):180. - PubMed
    1. Robinson BW, Lewis RR. Myocardial metastases from carcinoma of pancreas presenting as acute myocardial infarction. JR Soc Med. 1982;75(7):560–562. - PMC - PubMed
    1. Turiaf J, Battesti JP, Basset F, et al. Metastatic pleurisy in pancreatic cancer with the presence of considerable quantities of amylase in the pleural effusion and a major paraneoplastic peripheral neurologic syndrome. Ann Med Interne. 1969;120(6):449–458. - PubMed
    1. Takamori H, Kanemitsu K, Tsuji T, et al. Metastatic gastric tumor secondary to pancreatic adenocarcinoma. J Gastroenterol. 2005;40(2):209–212. - PubMed