Isolated metastatic tumors to the pancreas: Hôpital St-Antoine experience.

Mourra, Najat; Arrive, Lionel; Balladur, Pierre; Flejou, Jean-François; Tiret, Emmanuel; Paye, François

OBJECTIVES Metastatic tumors to the pancreas are rare and usually present a part of an advanced metastatic disease. Isolated metastasis is even rarer and may be difficult to differentiate from primary pancreatic neoplasm. The leading sources of metastases are breast, lung, kidney, and skin (melanoma). We present our experience with 12 cases of isolated pancreatic metastasis. METHODS We made a retrospective review from a series of pancreatic resections for metastatic disease, which occurred during the last decade. RESULTS The sites of origin were as follows: kidney (8 cases), lung (2 cases), bone (1 case), and breast (1 case). Only 4 patients were symptomatic (abdominal pain, 3 cases; melena, 1 case). The metastasis was metachronous in 11 cases, with mean disease-free interval of 9 years. The preoperative diagnosis was endocrine tumor in 4 cases. All patients underwent complete extirpation. At the time of follow-up, 3 patients had died of malignancy and 9 were still alive and free of disease, with a mean follow-up of 3 years. CONCLUSIONS Isolated metastatic tumors to the pancreas may be detected decades after the initial diagnosis and can be asymptomatic, emphasizing the need for lifelong surveillance in this population. Surgical extirpation of these lesions may offer the chance of long-term survival.