Solitary pancreatic metastasis from breast cancer: case report and review of literature

Apodaca-Rueda, Márcio; Chaim, Fábio Henrique Mendonça; Garcia, Milena da Silva; Saito, Helena Paes de Almeida de; Gestic, Martinho Antonio; Utrini, Murillo Pimentel; Callejas-Neto, Francisco; Chaim, Elinton Adami; Cazzo, Everton

doi:10.1590/1516-3180.2017.0144260617

Márcio Apodaca-Rueda

Medical Student, Faculdade de Medicina da Pontificia Universidade Católica de Campinas (PUC-Campinas), Campinas (SP), Brazil

Fábio Henrique Mendonça Chaim

MD. Resident Physician, Department of Surgery, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-UNICAMP), Campinas (SP), Brazil

Milena da Silva Garcia

MD. Resident Physician, Department of Surgery, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-UNICAMP), Campinas (SP), Brazil

Helena Paes de Almeida de Saito

MD. Assistant Lecturer, Oncology Unit - Department of Internal Medicine, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-UNICAMP), Campinas (SP), Brazil

Martinho Antonio Gestic

MD, MSc. Assistant Lecturer, Department of Surgery, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-UNICAMP), Campinas (SP), Brazil

Murillo Pimentel Utrini

MD, MSc. Assistant Lecturer, Department of Surgery, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-UNICAMP), Campinas (SP), Brazil

Francisco Callejas-Neto

MD, MSc. Assistant Professor, Department of Surgery, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-UNICAMP), Campinas (SP), Brazil

Elinton Adami Chaim

MD, MSc, PhD. Full Professor, Department of Surgery, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-UNICAMP), Campinas (SP), Brazil

Everton Cazzo

MD, PhD. Adjunct Professor, Department of Surgery, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-UNICAMP), Campinas (SP), Brazil

Address for correspondence: Everton Cazzo, Departamento de Cirurgia da Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-UNICAMP), Rua Alexander Fleming, s/n°, Cidade Universitária Zeferino Vaz — Campinas (SP) — Brasil, CEP 13085-000, Tel. (+55 19)3521-9450, E-mail: notrevezzo@yahoo.com.br

Conflict of interest: None

Medical Student, Faculdade de Medicina da Pontificia Universidade Católica de Campinas (PUC-Campinas), Campinas (SP), Brazil

MD. Resident Physician, Department of Surgery, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-UNICAMP), Campinas (SP), Brazil

MD. Assistant Lecturer, Oncology Unit - Department of Internal Medicine, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-UNICAMP), Campinas (SP), Brazil

MD, MSc. Assistant Lecturer, Department of Surgery, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-UNICAMP), Campinas (SP), Brazil

MD, MSc. Assistant Professor, Department of Surgery, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-UNICAMP), Campinas (SP), Brazil

MD, MSc, PhD. Full Professor, Department of Surgery, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-UNICAMP), Campinas (SP), Brazil

MD, PhD. Adjunct Professor, Department of Surgery, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-UNICAMP), Campinas (SP), Brazil

Electronic databases	Search strategies	Results
MEDLINE (PubMed)	(Breast neoplasms) AND (Pancreas) AND (Neoplasm Metastasis)	17 case reports 6 case series
LILACS (BVS)	(((Breast neoplasms) OR (Neoplasias da mama) OR (Neoplasias de la mama)) AND ((Pancreas) OR (Pâncreas) OR (Páncreas)) AND ((Neoplasm Metastasis) OR (Metástase Neoplásica) OR (Metástasis de la Neoplasia)))	1 case report

Authors	Breast cancer subtype	Age (years)	Disease-free interval (months)	Presenting symptoms	Location of metastases at diagnosis	Profile of the metastatic disease at diagnosis	Clinical management	Overall survival (months)
Akashi et al.⁶6. Akashi Y, Saiura A, Kishi Y, et al. Outcome after surgical resection of isolated metastases to the pancreas. Hepatogastroenterology. 2010;57(104):1549-52.	Lobular	47	41	NR	Head of pancreas	Solitary	Pancreaticoduodenectomy	28
Azzarelli et al.⁷7. Azzarelli A, Clemente C, Quagliuolo V, Battici F. A case of pancreatoduodenectomy as resolutive treatment for a solitary metastasis of breast cancer. Tumori. 1982;68(4):331-5.	Lobular	49	43	Jaundice	Head of pancreas	Solitary	Pancreaticoduodenectomy, radiation therapy	72
Bednar et al.⁸8. Bednar F, Scheiman JM, McKenna BJ, Simeone DM. Breast cancer metastases to the pancreas. J Gastrointest Surg. 2013;17(10):1826-31.	Lobular Phyllodes	75 57	96 48	Jaundice, pain Abdominal pain	Head of pancreas Head of pancreas, lung	Solitary Widespread disease	Pancreaticoduodenectomy Chemotherapy	48 15
Bonapasta et al.²2. Bonapasta SA, Gregori M, Lanza R, et al. Metastasis to the Pancreas from Breast Cancer: Difficulties in Diagnosis and Controversies inTreatment. Breast Care (Basel). 2010;5(3):170-3.	Ductal	51	24	Jaundice, pain	Head of pancreas	Solitary	Pancreaticoduodenectomy	36
Crippa et al.¹⁰10. Crippa S, Angelini C, Mussi C, et al. Surgical treatment of metastatic tumors to the pancreas: a single center experience and review of the literature. World J Surg. 2006;30(8):1536-42.	Lobular Lobular Lobular	46 70 57	60 36 84	Jaundice Jaundice, pain Jaundice, pain	Head of pancreas Head of pancreas Head of pancreas	Solitary Solitary Solitary	Pancreaticoduodenectomy Pancreaticoduodenectomy Pancreaticoduodenectomy	22 38 26
Dar et al.¹¹11. Dar FS, Mukherjee S, Bhattacharya S. Surgery for secondary tumors of the pancreas. HPB (Oxford). 2008;10(6):498-500.	Ductal	76	108	NR	Pancreas, liver	Widespread disease	Palliative bypass	6
Engel et al.¹²12. Engel JJ, Trujillo Y, Spellberg M. Metastatic carcinoma of the breast: a cause of obstructive jaundice. Gastroenterology. 1980;78(1 ):132-5.	Signet-ring cells	59	46	Pruritus, choluria	Head of pancreas	Solitary	Palliative bypass, Chemotherapy	15
Estraviz et al.¹³13. Estraviz B, Pocino R, Landaluce A, Mendarte U, Sarabia S. Metástases pancreática solitaria de carcinoma de mama [Solitary pancreatic metastasis from breast cancer]. Cirugía Española. 2002;72(2):111-2. Available from:http://www.elsevier.es/es-revista-cirugia-espanola-36-articulo-metastasis-pancreatica-solitaria-carcinoma-mama-S0009739X02720204. Accessed in 2017 (Aug 14). http://www.elsevier.es/es-revista-cirugi...	Ductal	56	36	Jaundice	Head of pancreas	Solitary	Pancreaticoduodenectomy	6 (still alive at the time of report)
Haque et al.¹⁴14. Haque S, Gopaldas RR, Plymyer MR, Glantz AI. Pancreatic mass of unusual etiology: case report of metastatic disease after a prolonged lag phase. Am Surg. 2005;71 (12):1082-5.	Lobular	85	168	Jaundice, pain	Head of pancreas	Solitary	Palliative bypass	NR
Kita m ura et al.¹⁵15. Kitamura N, Murata S, Abe H, et al. Obstructive jaundice in a metastatic tumor of the pancreas from breast cancer: a case report. Jpn J Clin Oncol. 2003;33(2):93-7.	Ductal	55	117	Jaundice	Head of pancreas	Solitary	Percutaneous drainage	1
Le Borgne et al.¹⁶16. Le Borgne J, Partensky C, Glemain P, Dupas B, de Kerviller B. Pancreaticoduodenectomy for metastatic ampullary and pancreatic tumors. Hepatogastroenterology. 2000;47(32):540-4.	Lobular	48	Synchronous	Jaundice	Head of pancreas	Solitary	Pancreaticoduodenectomy, chemotherapy	12
Mehta et al.¹⁷17. Mehta SA, Jagannath P, Krishnamurthy SC, De Souza LG. Isolated pancreatic metastasis from locally controlled breast cancer: a case report. Indian J Cancer. 1991 ;28(1 ):48-50.	Comedo type	30	36	Jaundice, pruritus	Head of pancreas	Solitary	Pancreaticoduodenectomy, chemotherapy, hormonal therapy	27
Molino et al.³3. Molino C, Mocerino C, Braucci A, et al. Pancreatic solitary and synchronous metastasis from breast cancer: a case report and systematic review of controversies in diagnosis and treatment. World J Surg Oncol. 2014; 12:2.	Lobular	68	Synchronous	Jaundice	Head of pancreas	Solitary	Pancreaticoduodenectomy, hormonal therapy	12 (still alive at the time of report)
Mountney etal.¹⁸18. Mountney J, Maury AC, Jackson AM, Coleman RE, Johnson AG. Pancreatic metastases from breast cancer: an unusual cause of biliary obstruction. Eur J Surg Oncol. 1997;23(6):574-6.	Lobular	57	16	Jaundice	Head of pancreas	Solitary	Palliative bypass, hormonal therapy	24
Moussa et al.¹⁹19. Moussa A, Mitry E, Hammel P, et al. Pancreatic metastases: a multicentric study of 22 patients. Gastroenterol Clin Biol. 2004;28(10 Pt 1 ):872-6.	Ductal Lobular	53 35	132 45	Acute pancreatitis Abdominal mass	Head of pancreas Body of pancreas	Solitary Solitary	Radiation therapy, chemotherapy, hormonal therapy Total pancreatectomy, chemotherapy	50 7
Nomizu et al.²⁰20. Nomizu T, Katagata N, Matsuoka T, et al. A Case of Breast Cancer Metastatic to the Head of the Pancreas. Breast Cancer. 1999;6(2):131-4.	Lobular	46	80	Jaundice	Head of pancreas	Solitary	Pancreaticoduodenectomy, chemotherapy, hormonal therapy	18
Odzak et al.²¹21. Odzak A, Geliberti F, Farace G, et al. Tumor de páncreas: presentación infrecuente de un carcinoma de mama oculto [Pancreatic tumor: an unusual presentation of an occult breast carcinoma]. Acta Gastroenterol Latinoam.2001;31(5):395-8.	Lobular	48	Synchronous	Jaundice, ascites	Head of pancreas	Widespread disease	Palliative care	NR
Pan et al.²²22. Pan B, Lee Y, Rodriguez T, Lee J, Saif MW. Secondary tumors of the pancreas: a case series. Anticancer Res. 2012;32(4):1449-52.	Lobular	59	182	Jaundice	Head of pancreas	Solitary	Chemotherapy, hormonal therapy	21
Pappo et al.²³23. Pappo I, Feigin E, Uziely B, Amir G. Biliary and pancreatic metastases of breast carcinoma: is surgical palliation indicated? J Surg Oncol. 1991;46(3):211-4.	Lobular	52	24	Jaundice	Pancreas, gallbladder	Widespread disease	Palliative bypass, hormonal therapy	16
Pérez Ochoa et al.²⁴24. Pérez Ochoa A, Sáez Hernáez F, Cajigas Fernández C, et al. Pancreatic metastases from ductal and lobular carcinomas of the breast. Clin Transl Oncol. 2007;9(9):603-5.	Lobular Ductal	60 55	1 108	Jaundice None	Head of pancreas, bone Tail of pancreas	Widespread disease Solitary	Biliary stent, pancreaticoduodenectomy, chemotherapy Distal pancreatectomy, splenectomy, chemotherapy	2 2
Razzetta et al.²⁵25. Razzetta F,Tassara E, Saro F, Sironi M, D’Ambrosio G. Rare abdominal metastases from occult lobular breast cancer: report of two cases. Updates Surg. 2011;63(2):129-33.	Lobular	51	Synchronous	Jaundice, pain, diarrhea	Head of pancreas, bone	Widespread disease	Pancreaticoduodenectomy, neoadjuvant chemotherapy, mastectomy	5
Tohnosu et al.²⁶26. Tohnosu N, Narushima K, Sunouchi K, et al. A case of breast cancer metastatic to the tail of the pancreas. Breast Cancer. 2006;13(2):225-9.	Scirrhous type	54	52	None	Tail of pancreas	Solitary	Distal pancreatectomy, chemotherapy, hormonal therapy	5
Z’graggen et al.²⁷27. Z’graggen K, Fernández-del Castillo C, Rattner DW, Sigala H, Warshaw AL Metastases to the pancreas and their surgical extirpation. Arch Surg. 1998;133(4):413-7; discussion 418-9.	Lobular	NR	96	Jaundice	Head of pancreas	Solitary	Biliary and gastric bypass, chemotherapy	54
Current study	Ductal	64	24	Pain	Tail of pancreas	Solitary	Distal pancreatectomy, chemotherapy	18 (still alive at the time of report)

[1] Address for correspondence: Everton Cazzo, Departamento de Cirurgia da Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-UNICAMP), Rua Alexander Fleming, s/n°, Cidade Universitária Zeferino Vaz — Campinas (SP) — Brasil, CEP 13085-000, Tel. (+55 19)3521-9450, E-mail: notrevezzo@yahoo.com.br

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Solitary pancreatic metastasis from breast cancer: case report and review of literature

ABSTRACT

CONTEXT:

CASE REPORT:

CONCLUSION: