Pancreatic neuroendocrine tumors (NETs) are one subgroup of gastroenteropancreatic NETs. Its main characteristics are slow growth, frequent metastasis to the liver, and limited to the liver for long periods. In patients with irresectable liver metastatic NET, liver transplantation is the only radical treatment. About 160 cases of liver transplantation for liver metastatic NET have been reported worldwide. However, there is no such report of liver transplantation for hepatic metastatic NET in China by now. We herein report a case of liver transplantation for hepatic metastatic pancreatic insulinoma with a survival of over 5 years.
Humans ; Insulinoma ; secondary ; therapy ; Liver Neoplasms ; complications ; Liver Transplantation ; Male ; Middle Aged ; Pancreatic Neoplasms ; secondary ; therapy

Pancreatic metastases are found in up to 40% of patients with small cell lung cancer, but metastasis-induced acute pancreatitis is rare. Treatment of metastasis-induced acute pancreatitis is initially supportive, but failure of conservative management are common. There are few reports on aggressive treatment with chemotherapy which lead to rapid clinical improvement and prolongation of survival in patients with metastasis-induced acute pancreatitis. We experienced a case of metastasis-induced acute pancreatitis in a patient with small cell lung cancer. Despite conservative treatment with dietary restriction and intravenous fluid supply, serum amylase levels increased persistently with severe abdominal pain. After chemotherapy with irinotecan and carboplatin, abdominal pain and serum amylase levels resolved dramatically.
Acute Disease ; Aged ; Carcinoma, Small Cell/*secondary ; English Abstract ; Humans ; Lung Neoplasms/*pathology ; Male ; Pancreatic Neoplasms/complications/*secondary ; Pancreatitis/*etiology

Carcinoma ; diagnostic imaging ; secondary ; Humans ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; pathology ; Pancreatic Neoplasms ; diagnostic imaging ; secondary ; Ultrasonography

Cutaneous metastases from pancreatic adenocarcinomas are rare lesions. The most common site of cutaneous metastasis is the umbilicus, and this is also known as the 'Sister Mary Joseph' nodule. A 68-year-old Korean male, who was previously healthy and asymptomatic, was seen in the dermatology department for two subcutaneous nodules that he had on his right forearm and his back. Histological examination of the right foreman nodule revealed metastatic adenocarcinoma. Immunohistochemical staining for cytokeratin (CK) 7 and CK 19 were positive, and this strongly suggested the pancreatic duct as being the primary source of the cancer. The abdominal computed tomography findings were compatible with pancreatic cancer. Clinicians should be aware that metastatic cutaneous lesions could be the initial presenting sign for pancreatic cancer. The immunohistochemical staining for CK 7 and 19 may also be helpful in the diagnosis of metastatic pancreatic adenocarcinoma.
Skin Neoplasms/diagnosis/*secondary ; Pancreatic Neoplasms/*pathology ; Neoplasm Metastasis/*pathology ; Male ; Korea ; Humans ; Aged ; Adenocarcinoma/*pathology

Female ; Heart Neoplasms ; complications ; secondary ; Humans ; Middle Aged ; Pancreatic Neoplasms ; pathology ; Ventricular Outflow Obstruction ; etiology

Carcinoma, Squamous Cell ; pathology ; Humans ; Liver Neoplasms ; secondary ; Male ; Middle Aged ; Pancreatic Neoplasms ; pathology

OBJECTIVETo investigate the clinicopathologic characteristics and differential diagnosis of the metastases to the breast from non-mammary malignancies.

METHODSTwenty-eight cases were collected from 2004 to 2012;microscopic pathologic examinations and immunohistochemistry (EnVision method) were performed.

RESULTS(1) All except one patients were female, ranging from 16 to 77 years old (average 45.8 years). Twenty-six (92.9%) patients initially presented with the primary site lesions; while the other two (7.1%) patients initially presented with breast lesions. The mean interval from primary diagnosis to detection of metastatic breast lesions was 32 months (0-228 months). Fifteen patients (53.6%) had other metastases detected simultaneously or preceded the breast lesions. (2) Macroscopically, all the tumors were relatively circumscribed, with a mean diameter of 4.0 cm (0.6-12.0 cm). The histological types of the corresponding primary tumors were as follows: eight (28.6%) cases from lung adenocarcinoma, five (17.8%) from high-grade ovarian serous carcinoma, three (10.7%) from gastric adenocarcinoma, two (7.1%) from rectal adenocarcinoma, one (3.6%) from pancreatic neuroendocrine carcinoma, one (3.6%) from prostatic carcinoma, four (14.3%) from melanoma, and four (14.3%) from mesenchymal malignant tumors (three rhabdomyosarcomas and one epithelioid malignant peripheral nerve sheath tumor, MPNST). (3) Histologically, the metastatic tumors showed the morphologic characteristics of the primary tumors. Lymph-vascular invasion was observed in 19 cases. Immunohistochemical features of metastatic tumors were consistent with the primary tumors. Molecular markers for breast such as GCDFP15 and mammaglobin were negative. Metastatic tumors from lung adenocarcinoma expressed TTF-1 (8/8). Ovarian serous carcinoma metastases were positive for PAX8 (5/5) and WT1 (4/5). Gastric adenocarcinoma metastases were positive for CDX2 (3/3) and villin (1/3). Rectal adenocarcinoma metastases were positive for CDX2 (2/2). Pancreatic neuroendocrine tumor metastasis was positive for Syn and CgA (both 1/1). Prostate carcinoma metastasis was positive for AR, PSA and P504S (all 1/1). Melanoma metastases were positive for HMB45 (2/3) and S-100 protein (3/3). Rhabdomyosarcoma metastases were positive for vimentin, desmin and myoD1 (all 3/3). MPNST metastasis was positive for S-100 protein (1/1). (4) Follow-up data was available in 17 patients, with median follow-up time 54 months. The median survival from diagnosis to breast metastasis was 24 months.Seven of 17 patients died.

CONCLUSIONSMetastases to the breast from non-mammary malignancies are rare and show pathologic features of primary tumors. It is usually presumed to be a primary breast carcinoma. Histopathologic features and clinical history in conjunction with the immunohistochemical results should be considered in differentiating a secondary mass from a primary breast carcinoma.

Adenocarcinoma ; secondary ; Adolescent ; Adult ; Aged ; Biomarkers, Tumor ; metabolism ; Breast Neoplasms ; pathology ; secondary ; surgery ; Breast Neoplasms, Male ; pathology ; secondary ; surgery ; Carcinoma, Neuroendocrine ; secondary ; Cystadenocarcinoma, Serous ; secondary ; Female ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Lung Neoplasms ; pathology ; Lymph Node Excision ; Lymphatic Metastasis ; Male ; Mastectomy ; Melanoma ; secondary ; Middle Aged ; Ovarian Neoplasms ; pathology ; Pancreatic Neoplasms ; pathology ; Rectal Neoplasms ; pathology ; Rhabdomyosarcoma ; secondary ; Stomach Neoplasms ; pathology ; Treatment Outcome ; Young Adult

We present here a very rare case of metastatic relapse in the pancreas of a 4-year-old boy who had been treated for stage 4 neuroblastoma. Computed tomography showed multiple metastatic masses in the pancreas with secondary pancreatitis. To the best of our knowledge, this is the first case report of pancreatic metastasis in a child with neuroblastoma.
Adrenal Gland Neoplasms/diagnosis/*pathology ; Child, Preschool ; Contrast Media ; Diagnosis, Differential ; Diagnostic Imaging ; Humans ; Male ; Neuroblastoma/diagnosis/*secondary ; Pancreatic Neoplasms/diagnosis/*secondary

A solid-pseudopapillary tumor (SPT) of the pancreas is known as a low grade malignant tumor with a good prognosis; therefore, surgical intervention is necessary. A 14-year-old boy presented with a large pancreatic SPT and three hepatic metastases. The patient and his family refused surgery. Two serial follow-up CT scans over a period of 13 years demonstrated almost complete disappearance of the pancreatic tumor and three hepatic metastases without relevant treatment. Although there have been a few reports of spontaneous healing of SPT, there has been no report regarding spontaneous disappearance of SPT and distant metastasis. Herein, we report on the spontaneous regression of a large SPT and the disappearance of three hepatic metastases.
Adolescent ; Carcinoma, Papillary/radiography/*secondary ; Humans ; Liver Neoplasms/radiography/*secondary ; Male ; Pancreatic Neoplasms/*pathology/radiography ; Remission, Spontaneous ; Tomography, X-Ray Computed

No abstract available.
Aged, 80 and over ; Biopsy ; Carcinoma, Papillary/chemistry/*secondary ; Female ; Humans ; Immunohistochemistry ; Liver Neoplasms/chemistry/*secondary ; Pancreatic Neoplasms/chemistry/*pathology ; Tumor Markers, Biological/analysis