Pancreatic metastases: a multicentric study of 22 patients

To evaluate the diagnosis, treatment and outcome of patients with pancreatic metastases. We retrospectively reviewed the records of patients with pancreatic metastasis managed in the Paris area between 1990 and 2000. The series analyzed included 22 patients, 10 men and 12 women, mean age 61 years (range: 35-76). The primary tumors were renal-cell carcinoma (N = 10), colorectal cancer (N = 4), lung cancer (N = 4), breast cancer (N = 2), cutaneous melanoma (N = 1) and ileal carcinoid (N = 1). The mean interval between primary treatment and presentation was 73.5 months (range: 2-151). Diagnosis was established because of clinical symptoms (N = 15) or during surveillance (N = 7). Computed tomography (N = 19) and endoscopic ultrasound (EUS) (N = 18) mainly showed solitary and hypodense/or hypoechoic masses. Histological diagnosis was obtained before surgery by EUS-guided fine needle aspiration (N = 6), ultrasound-guided biopsy (N = 3) or duodenoscopy (N = 3). Among 10 patients with primary renal-cell carcinoma, 7 were treated by surgery. Median global survival was 33 months. Median survival was 61 months in the event of surgical treatment and 20 months in the other patients (ns). Mean survival depended on the type of primary tumor, 61 months for renal-cell carcinoma and 33 for colorectal cancer (P = 0.06). Most pancreatic metastases develop from renal-cell carcinoma and can occur several years after nephrectomy. Histological diagnosis is often obtained before surgery. Surgical resection must be discussed as it can allow long-term survival. Étudier les caractéristiques des malades ayant des métastases pancréatiques en termes diagnostique, thérapeutique et pronostique. Vingt-deux malades pris en charge en région parisienne entre 1990 et 2000 ont été étudiés rétrospectivement. Il s’agissait de 10 hommes et 12 femmes d’âge moyen 61 ans (extrêmes: 35-76). La tumeur primitive était un cancer rénal (N = 10), colo-rectal (N = 4), pulmonaire (N = 4), mammaire (N = 2), un mélanome cutané (N = 1) et une tumeur endocrine de l’iléon (N = 1). Le délai médian d’apparition des métastases était de 73,5 mois (extrêmes: 2-151). Le diagnostic était évoqué à l’occasion de manifestations cliniques (N = 15) ou au cours de la surveillance (N = 7). La tomodensitométrie (N = 19) et l’échoendoscopie (n = 18) montraient le plus souvent une lésion unique, focale, hypodense et hypoéchogène. Un diagnostic histologique de certitude pré-opératoire était obtenu 12 fois (ponction sous échoendosc