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• W2914630561 abstract "Accounting for 2-5% of exocrine pancreatic tumors, mucinous cystic neoplasms (MCN) are considered a rare manifestation with a female predominance. These neoplasms of the pancreas are biologically less aggressive than de novo pancreatic adenocarcinoma, and their propensity for metastasis is low. We report an case of an isolated vertebral metastases from a pancreatic adenocarcinoma arising within a cystic neoplasm of the pancreas. This case highlights that slow growing MCN tumors can have unusual patterns of metastases and bolsters the need for careful evaluation of staging tests, including a complete evaluation of the vertebrae. A 63 year old female presented to the E.D. complaining of diffuse abdominal pain & bloating over 4 months. Computed tomography (CT) revealed a cystic abdominal lesion originating from the body and tail of the pancreas. There was no associated pancreatic duct dilatation or solid component visualized. CA199 and CEA levels were elevated with no other lab abnormalities. An endoscopic ultrasound was performed which confirmed a cystic lesion at the body/tail of the pancreas with a mural nodule both of which were aspirated and biopsied, respectively. The biopsies confirmed adenocarcinoma of the pancreas. On review of CT and a subsequent magnetic resonance imaging (MRI) a single hyper dense lesion at L1 was noted and was confirmed to be metastatic pancreatic adenocarcinoma by biopsy. Surgery was no longer warranted and the patient was offered palliative chemotherapy. To the best of our knowledge, this is the first report of an isolated vertebral metastasis from pancreatic cancer originating from an MCN. Pancreatic cystic lesions (PCL) are classified as Non-neoplastic cysts [serous cystadenomas, pseudocysts, epithelial cysts]; and Cystic Neoplasms [intraductal papillary mucinous neoplasm (IPMN) and mucinous cystic neoplasm (MCN)]. Overall, cystic neoplasms of the pancreas have a low risk of malignancy; the estimated risk of malignancy is 0.01-0.21 % depending on cyst size. A Japanese multicenter study in 2004 found that the 5-year survival rate of MCN patients was 100% in adenoma to minimally invasive carcinoma cases and 37.5% in invasive carcinoma cases, yet no cases to date have ever reported isolated distant metastasis to the vertebrae. This case reinforces that even slow growing cystic neoplasms of the pancreas can have unusual patterns of spread; and vigilance to this finding is paramount to making effective management decisions.Figure: Endoscopic Ultrasound: Mucinous Pancreatic Mass with Mural Nodule.Figure: MCN of the Pancreas and Vertebral Metastasis with Corresponding Pathology." @default.
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• W2914630561 date "2017-10-01" @default.
• W2914630561 modified "2023-09-25" @default.
• W2914630561 title "Rare Cystic Neoplasm of the Pancreas With Isolated Metastases to Vertebrae" @default.
• W2914630561 doi "https://doi.org/10.14309/00000434-201710001-01289" @default.
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