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Rais K, El Eulj O, El Moutaoukil N, Kamaoui I, Bennani A, Kharrasse G, Zazour A, Khannoussi W, Ismaili Z. Solitary pancreatic metastasis from squamous cell lung carcinoma: A case report and review of literature. World J Gastrointest Endosc 2022; 14:455-466. [PMID: 36051994 PMCID: PMC9329848 DOI: 10.4253/wjge.v14.i7.455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/18/2022] [Accepted: 06/16/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Pancreatic metastases from squamous cell lung carcinoma (SCLC) are unusual. These lesions are often asymptomatic and detected incidentally or during follow-up investigations, occasionally several years after removal of the primary tumor.
CASE SUMMARY A 56-year-old male with SCLC developed jaundice 1 mo after the cancer diagnosis. An abdominal computed tomography (CT) scan showed a mass in the pancreatic head with distention of both intra- and extrahepatic biliary ducts. Endoscopic retrograde cholangiopancreatography and sphincterotomy were performed first, culminating with plastic biliary stent placement. Cytological examination of the pancreatic mass sample collected by fine-needle aspiration (FNA) under endoscopic ultrasound (EUS) guidance revealed the presence of malignant cells compatible with well-differentiated squamous cell carcinoma. After liver function normalized, chemotherapy was initiated with carboplatin and paclitaxel; however, 4 d later, the patient presented dysphagia. Cervico-thoraco-abdominal CT showed tracheoesophageal fistula and stent migration. After replacement with a 10 cm/10 mm uncovered metallic biliary stent and treatment of the tracheoesophageal fistula with a fully covered esophageal stent, the patient was able to start oral feeding progressively. He died 9 mo after the initial diagnosis.
CONCLUSION The diagnosis of pancreatic metastasis from SCLC is challenging for clinicians. EUS-FNA is the primary exam for confirmatory diagnosis.
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Affiliation(s)
- Kaouthar Rais
- Department of Hepatogastroenterology, Mohammed VI University Hospital Center, Digestive Disease Research Laboratory, Medical School, Mohammed I University, Oujda 60000, Morocco
| | - Oumayma El Eulj
- Department of Hepatogastroenterology, Mohammed VI University Hospital Center, Digestive Disease Research Laboratory, Medical School, Mohammed I University, Oujda 60000, Morocco
| | - Najoua El Moutaoukil
- Department of Hepatogastroenterology, Mohammed VI University Hospital Center, Digestive Disease Research Laboratory, Medical School, Mohammed I University, Oujda 60000, Morocco
| | - Imane Kamaoui
- Department of Radiology, Mohammed VI University Hospital Center, Digestive Disease Research Laboratory, Medical School, Mohammed I University, Oujda 60000, Morocco
| | - Amal Bennani
- Department of Anatomo-Pathology, Mohammed VI University Hospital Center, Digestive Disease Research Laboratory, Medical School, Mohammed I University, Oujda 60000, Morocco
| | - Ghizlane Kharrasse
- Department of Hepatogastroenterology, Mohammed VI University Hospital Center, Digestive Disease Research Laboratory, Medical School, Mohammed I University, Oujda 60000, Morocco
| | - Abdelkrim Zazour
- Department of Hepatogastroenterology, Mohammed VI University Hospital Center, Digestive Disease Research Laboratory, Medical School, Mohammed I University, Oujda 60000, Morocco
| | - Wafaa Khannoussi
- Department of Hepatogastroenterology, Mohammed VI University Hospital Center, Digestive Disease Research Laboratory, Medical School, Mohammed I University, Oujda 60000, Morocco
| | - Zahi Ismaili
- Department of Hepatogastroenterology, Mohammed VI University Hospital Center, Digestive Disease Research Laboratory, Medical School, Mohammed I University, Oujda 60000, Morocco
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Yuan P, Zhang L, Li S, Li X, Wu Q. Clinical results after biliary drainage by endoscopic retrograde cholangiopancreatography for analysis of metastatic cancer survival and prognostic factors. Surg Endosc 2020; 35:6220-6226. [PMID: 33140156 DOI: 10.1007/s00464-020-08121-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 10/21/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Malignant biliary obstruction secondary to metastatic cancer is associated with poor prognosis. To the best of our knowledge, no previous study has investigated long-term survival and associated prognostic factors after biliary endoscopic retrograde cholangiopancreatography (ERCP) drainage for obstruction jaundice secondary to various types of metastatic cancer. METHODS This retrospective study included 60 patients who underwent biliary ERCP drainage for obstructive jaundice secondary to metastatic cancer at two hospitals during the period from November 2012 to December 2019. Multivariate analysis was conducted to identify independent prognostic factors. RESULTS Biliary drainage was successfully achieved in 55 (91.7%) patients, 37 of whom received subsequent treatment. Overall median survival time was 133 days after stent placement. The overall survival (OS) rates after ERCP drainage were significantly better in the post-drainage treatment group than in the post-drainage untreated group (239 days vs. 45 days, p < 0.001). Good ECOG performance status before drainage, albumin level ≥ 35 g/L, successful drainage, absence of ascites, and post-drainage treatment were identified as factors of improved survival in univariate analysis. ECOG performance status and post-drainage treatment were independent predictors of OS in multivariate analysis. CONCLUSIONS We showed that stent placement with ERCP was a safe and effective treatment method for patients with malignant biliary obstruction caused by metastatic cancer and may be preferred over percutaneous transhepatic biliary drainage. Post-drainage treatment and a good ECOG performance status were predictors of better prognosis.
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Affiliation(s)
- Peng Yuan
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Endoscopy, Peking University Cancer Hospital and Institute, #52, Fucheng Road, Haidian, Beijing, People's Republic of China
| | - Lei Zhang
- Department of Hepatobiliary Surgery, The First Hospital of Lanzhou University, Lanzhou, People's Republic of China
| | - Shijie Li
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Endoscopy, Peking University Cancer Hospital and Institute, #52, Fucheng Road, Haidian, Beijing, People's Republic of China
| | - Xun Li
- Department of Hepatobiliary Surgery, The First Hospital of Lanzhou University, Lanzhou, People's Republic of China.
| | - Qi Wu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Endoscopy, Peking University Cancer Hospital and Institute, #52, Fucheng Road, Haidian, Beijing, People's Republic of China.
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