Metastatic tumors to the pancreas: The role of surgery

Abstract

Pancreatic metastases from other primary malignancies are a rare entity. By far, the most common primary cancer site resulting in an isolated pancreatic metastasis is the kidney, followed by colorectal cancer, melanoma, breast cancer, lung carcinoma and sarcoma. Only few data on the surgical outcome of pancreatic resections performed for metastases from other primary tumor have been published, and there are no guidelines to address the surgical treatment for these patients. In this study, we performed a review of the published literature, focusing on the early and long-term results of surgery for the most frequent primary tumors metastasizing to the pancreas. Results for the Literature's analysis show that in last years an increasing number of surgical resections have been performed in selected patients with limited pancreatic disease. Pancreatic resection for metastatic disease can be performed with acceptable mortality and morbidity rates. The usefulness of pancreatic resection is mainly linked to the biology of the primary tumor metastasizing to the pancreas. The benefit of metastasectomy in terms of patient survival has been observed for metastases from renal cell cancer, while for other primary tumors, such as lung and breast cancers, the role of surgery is mainly palliative.

Keywords: Breast cancer; Lung carcinoma; Melanoma; Pancreas; Pancreatectomy; Pancreatic neoplasms/secondary; Renal cell cancer; Sarcoma.

Figure 1

Computed tomography scan of the abdomen. A: Computed tomography (CT) scan of the abdomen showing a contrast-enhanced pancreatic metastasis from a renal cell carcinoma; B: CT scan of the abdomen showing an hypodense metastatic lesion of the pancreatic head from a colon carcinoma.

Figure 2

Positron emission tomography/computed tomography imaging showing a pathologic uptake of the tracer in the region of the pancreatic neck and in the left lung from a melanoma.