Retrospective Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. Mar 28, 2016; 8(3): 316-321
Published online Mar 28, 2016. doi: 10.4329/wjr.v8.i3.316
Multidetector computed tomography features of pancreatic metastases from leiomyosarcoma: Experience at a tertiary cancer center
Chong Hyun Suh, Abhishek Keraliya, Atul B Shinagare, Kyung Won Kim, Nikhil H Ramaiya, Sree Harsha Tirumani
Chong Hyun Suh, Kyung Won Kim, Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 138-736, South Korea
Chong Hyun Suh, Department of Radiology, Namwon Medical Center, Jeollabuk-Do 590-702, South Korea
Abhishek Keraliya, Atul B Shinagare, Nikhil H Ramaiya, Sree Harsha Tirumani, Department of Imaging, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA 02115, United States
Abhishek Keraliya, Atul B Shinagare, Nikhil H Ramaiya, Sree Harsha Tirumani, Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, United States
Author contributions: Shinagare AB and Ramaiya NH designed the research; Suh CH, Keraliya A and Tirumani SH performed the research; Shinagare AB and Kim KW contributed new reagents/analytic tools; Suh CH, Kim KW and Tirumani SH analyzed the data; Suh CH and Tirumani SH wrote the paper.
Institutional review board statement: The study was approved by the institutional review board.
Informed consent statement: Informed consent was waived by the institutional review board.
Conflict-of-interest statement: None of the authors have any conflicts of interest pertaining to the content in the manuscript. Dr. Shinagare is a recipient of RSNA research grant unrelated to the current study.
Data sharing statement: No additional data available.
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: Sree Harsha Tirumani, MD, Department of Imaging, Dana Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA 02115, United States. stirumani@partners.org
Telephone: +1-617-6326312 Fax: +1-617-5828574
Received: August 20, 2015
Peer-review started: August 22, 2015
First decision: November 6, 2015
Revised: November 15, 2015
Accepted: January 5, 2016
Article in press: January 7, 2016
Published online: March 28, 2016
Processing time: 213 Days and 22.3 Hours
Abstract

AIM: To describe the multidetector computed tomography features of pancreatic metastasis from leiomyosarcoma (LMS).

METHODS: Between January 1995 and December 2012, 13 consecutive patients (11 women, 2 men; mean age of 57 years; range, 38-78 years) with pancreatic metastases from LMS were included in our study. Imaging features including location, number, largest dimension, tumor attenuation and enhancement characteristics, presence of necrosis, pancreatic ductal dilatation, common bile duct (CBD) dilatation, presence of pancreatitis, and atrophy were documented.

RESULTS: The most common site of origin of the pancreatic metastases from LMS was uterus (38.5%), followed by retroperitoneum (30.8%) and extremity (23.1%). None of the patients in our study had pancreas as the first site of metastasis. All patients developed pancreatic metastases at a median interval of 24 mo. Pancreatic metastases from LMS were solitary in 8/13 patients and multiple in 5/13 patients, had no predilection for any part of the pancreas, were hypovascular on arterial phase in 10/13 patients and associated with pancreatic duct dilatation in 3/13 patients. None had CBD dilatation. None of the pancreatic metastases in LMS cohort caused pancreatitis, and atrophy. Median duration of follow-up was 19 mo for LMS cohort during which two patients underwent resection of metastasis (median survival 45 mo) while the remaining underwent systemic therapy (median survival 13 mo).

CONCLUSION: Pancreatic metastases from LMS are often solitary and hypovascular masses and less commonly associated with pancreatic ductal dilatation, CBD dilatation, pancreatitis or pancreatic atrophy. Surgical resection of solitary LMS pancreatic metastasis can be considered due to the long survival of these patients.

Keywords: Pancreatic metastasis; Hypovascular; Renal cell carcinoma; Leiomyosarcoma; Multidetector computed tomography

Core tip: Pancreatic metastases from leiomyosarcoma (LMS) commonly arise in the uterus and are characterized by a long latency period after the diagnosis of primary tumor. Although the imaging features of the pancreatic metastases from LMS are nonspecific, pancreatic metastases from LMS should be considered in the differential diagnosis of solitary or multiple hypovascular masses without pancreatic ductal dilatation, common bile duct dilatation, pancreatitis, atrophy in the pancreas in patients with history of LMS. Surgical resection of solitary LMS pancreatic metastasis can be considered due to the long survival of these patients after detection of pancreatic metastasis.