Pancreatic metastasis from a rectal cancer

Alina Constantin¹, Cătălin Copăescu², Adrian Săftoiu³

1. Gastroenterology Department, Ponderas Academic Hospital Bucharest
2. Surgical Department, Ponderas Academic Hospital Bucharest
3. Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy Craiova, Romania

Endoscopic ultrasound elastography (Fig. 1) + Contrast enhanced harmonic EUS (CE-EUS) (Fig. 2, Movie 1) + EUS-fine needle biopsy (FNB) (Fig. 3). Malignant pancreatic tumors are typically stiff hypoenhanced lesions.

For contrast-enhanced EUS, a peripheral rim (visible during microbubble trace imaging mode) with central hypoenhancement in the arterial and venous phase is suggestive of a pancreatic metastasis. In patients with a personal history of a colorectal cancer this indicates the need to use a histological needle biopsy followed by immunohistochemistry (IHC) analysis, performed in order to rule out pancreatic metastasis.

Featured reference

Palazo M., Role of contrast harmonic endoscopic ultrasonography in other pancreatic solid lesions: Neuroendocrine tumors, autoimmune pancreatitis and metastases. Endoscopic Ultrasound, 2016, Volume 5, Issue 6 [p. 373-376]