Department of Anatomical Pathology, Hepatology and Nutrition, University of Texas MD Anderson Cancer Center, Houston.
Department of Gastroenterology, Hepatology and Nutrition, University of Texas MD Anderson Cancer Center, Houston.
Am J Clin Pathol. 2020 Oct 13;154(5):692-699. doi: 10.1093/ajcp/aqaa090.
Solid tumor metastases to the pancreas are rare, and only limited literature on the topic is available. In this retrospective study, we reviewed 107 cases of solid tumor metastases to the pancreas diagnosed by fine-needle aspiration (FNA) from 2005 to 2019.
Information including the patients' clinical histories, radiologic and pathologic findings, treatments, and follow-up were collected.
The mean age of the patients was 62.4 years. The mean tumor size was 2.64 cm with even distribution throughout the pancreas (head, neck and body, and tail). The most common primary site was the kidney, followed by the lung, skin, and breast and the gynecologic, gastrointestinal, and genitourinary tracts. The most common tumor type was carcinoma, followed by melanoma and sarcoma. In comparison to patients with nonkidney primary cancers, those with primary renal cell carcinoma had a longer median interval between primary diagnosis and metastasis (8.5 vs 4.0 years; P < .01), less often had metastasis outside the pancreas (38% vs 74%; P < .01), and had a significantly longer 5-year survival rate (65.7% vs 24.8%; P < .01).
FNA plays a crucial role in diagnosing metastases to the pancreas. Metastases originating from kidney and nonkidney primary tumors have distinct clinicopathologic features and prognoses.
胰腺的实体瘤转移较为罕见,目前仅有少量相关文献。本回顾性研究收集了 2005 年至 2019 年期间通过细针穿刺(FNA)诊断的 107 例胰腺实体瘤转移病例。
收集患者的临床病史、影像学和病理学发现、治疗方法和随访等信息。
患者的平均年龄为 62.4 岁,肿瘤平均大小为 2.64cm,均匀分布于胰腺(头部、颈部和体部、尾部)。最常见的原发部位是肾脏,其次是肺、皮肤和乳腺以及妇科、胃肠道和泌尿生殖道。最常见的肿瘤类型是癌,其次是黑色素瘤和肉瘤。与非肾脏原发癌患者相比,原发肾细胞癌患者原发诊断与转移之间的中位间隔时间更长(8.5 年 vs 4.0 年;P <.01),胰腺外转移的发生率更低(38% vs 74%;P <.01),5 年生存率显著更高(65.7% vs 24.8%;P <.01)。
FNA 在诊断胰腺转移中发挥着关键作用。来源于肾脏和非肾脏原发肿瘤的转移具有不同的临床病理特征和预后。