Akpinar B, Obuch J, Fukami N, Pokharel SS. Unusual presentation of a pancreatic cyst resulting from osteosarcoma metastasis. World J Gastroenterol 2015; 21(27): 8452-8457 [PMID: 26217098 DOI: 10.3748/wjg.v21.i27.8452]
Corresponding Author of This Article
Burcu Akpinar, MD, Visiting Research Scholar, Department of Radiology, University of Colorado Hospital, 12401 E. 17th Ave, Mail Stop L954, Aurora, CO 80045-2548 United States. burcu.akpinar@ucdenver.edu
Research Domain of This Article
Radiology, Nuclear Medicine & Medical Imaging
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Jul 21, 2015; 21(27): 8452-8457 Published online Jul 21, 2015. doi: 10.3748/wjg.v21.i27.8452
Unusual presentation of a pancreatic cyst resulting from osteosarcoma metastasis
Burcu Akpinar, Joshua Obuch, Norio Fukami, Sajal S Pokharel
Burcu Akpinar, Sajal S Pokharel, Department of Radiology, University of Colorado Hospital, Aurora, CO 80045-2548, United States
Joshua Obuch, Norio Fukami, Division of Gastroenterology and Hepatology, University of Colorado Hospital, Aurora, CO 80045-2548, United States
Author contributions: Akpinar B designed the report, collected and analyzed the data; Obuch J collected and analyzed the data, and revised the case report; Pokharel SS designed the report, and revised the case report; and Fukami N collected the data, and revised the case report.
Institutional review board statement: The study was reviewed by Colorado Multiple Institutional Review Board with protocol number 14-2233 and determined as not human subject research as defined by the policies in accordance with Office for Human Research Protections and Food and Drug Administration regulations.
Informed consent statement: We do not have a signed informed consent from the patient for this case report. The case report was conceived after discharge of the patient from our hospital. We kindly request an exemption from the informed consent requirement as we have not had any encounter with the patient after the last appointment in August in our hospital.
Conflict-of-interest statement: Authors have no conflict of interest related to the manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Burcu Akpinar, MD, Visiting Research Scholar, Department of Radiology, University of Colorado Hospital, 12401 E. 17th Ave, Mail Stop L954, Aurora, CO 80045-2548 United States. burcu.akpinar@ucdenver.edu
Telephone: +1-765-7168306 Fax: +1-720-8487315
Received: October 29, 2014 Peer-review started: October 29, 2014 First decision: November 14, 2014 Revised: December 2, 2014 Accepted: January 16, 2015 Article in press: January 16, 2015 Published online: July 21, 2015 Processing time: 64 Days and 1.6 Hours
Abstract
Pancreatic metastases are uncommon. They have been reported in lung cancer, gastrointestinal malignancies, breast cancer, renal cell carcinoma, melanoma, lymphoma and sarcoma, and usually have solid morphology. Cystic metastasis to the pancreas is even more rare with few case reports in the literature. However, with the increasing use of computed tomography and magnetic resonance imaging as well as endoscopic ultrasound, more such lesions may be detected. Metastasis to the pancreas from osteosarcoma is highly unusual, but can be seen with the increasing survival of patients with osteosarcoma. We present an extremely rare case of a predominantly cystic lesion of the pancreas, which was diagnosed as metastasis from osteosarcoma. The pathophysiology of the cystic component of the metastasis of osteosarcoma is unknown. Cystic necrotic degeneration of the solid metastasis or pancreatitis secondary to the metastasis with development of associated fluid collection can be considered. Metastasis should remain a differential consideration even for primarily cystic lesions of the pancreas.
Core tip: Cystic pancreatic lesions are more commonly recognized and diagnosed with developing imaging technologies. Metastasis to the pancreas from osteosarcoma is unusual, but has been reported in terms of solid pancreatic masses. This case report shows that metastasis should remain in the differential diagnosis even for primarily cystic pancreatic lesions.
