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Endoscopic ultrasound guided-fine needle aspiration for the diagnosis of secondary pancreatic lesions. Experience of a reference center
Background
It is estimated that about 2% to 5% of pancreatic malignant tumors are metastatic lesions. Lung, kidney and breast cancer as well as melanoma are the most common primary tumors affecting the pancreas. Histologic or cytologic confirmation is essential for differential diagnosis from the much more common primary adenocarcinoma of the pancreas. The aim of this study is to assess the diagnostic value and safety of endoscopic ultrasound guided-fine needle aspiration (EUS-FNA) of pancreatic tumors in patients with extra-pancreatic malignancy.
Methods
A total number of 306 patients with solid pancreatic tumor underwent EUS- FNA from 1/1/2011 to 17/03/2022 by a single operator (DT) in the Gastroenterology-Oncology Department. Thirty-four patients with a history of extra-pancreatic malignancy and pancreatic mass, found either on follow up imaging or due to symptom assessment, were retrospectively studied. The type of malignancy history, the results of the cytologic examination, the needle size, the number of passes performed, as well as the serious adverse events were recorded.
Results
Thirty-four patients were included in the study, 16 (47%) male, with mean age 67.8 years. Nine patients had breast cancer (27%), 6 lung cancer (18%), 7 kidney cancer (21%), 5 melanoma (15%) and 8 with other malignancies (endometrium, colon, lymphoma). The cytologic examination showed primary pancreatic carcinoma in 13 patients (41%) and metastasis in nine patients (27%). The most common origin of metastasis was lung cancer (43%) followed by melanoma and breast cancer (29% each). The most commonly used needle size was 22G (76%) and 25G (24%). The average number of passes performed was 3.9 with negative pressure suction technique. No serious complications were reported.
Conclusions
The possibility of metastasis to the pancreas is not negligible in patients with extra- pancreatic malignancy and pancreatic tumor. EUS-FNA is safe and effective in the assessment of pancreatic masses in a large number of patients, contributing to the appropriate therapeutic treatment.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosures
All authors have declared no conflicts of interest.
