Ann Hepatobiliary Pancreat Surg.  2017 Nov;21(4):247-251. 10.14701/ahbps.2017.21.4.247.

Metastatic adenocarcinoma of the pancreas presents as metastases to the axillary/supraclavicular region as the first sign of the disease

• Stewart BA
• Adjei A
• Zhang X
• Oxenberg J

• KMID: 2397808
• DOI: http://doi.org/10.14701/ahbps.2017.21.4.247

Abstract

Mucinous tumors of the pancreas are rare and the diagnosis of invasive carcinoma can be a dilemma. While metastatic disease from mucinous cystadenocarcinoma (MCAC) and invasive intraductal papillary mucinous neoplasms (IPMN) have been reported, no extraperitoneal mucinous cystic metastatic disease has been described. When metastatic, the overall survival rates for invasive adenocarcinoma, mucinous cystadenocarcinoma (MCAC) and invasive intraductal papillary mucinous neoplasms (IPMN) are similar. The best improvement in the overall and progression free survival has been demonstrated with FOLFIRINOX (folinic acid - fluorouracil - irinotecan - oxaliplatin) for metastatic adenocarcinoma and Gemcitabine based regimens for MCAC. However, the variable responses of metastatic mucinous lesions have been observed and the overall prognosis remains poor. We describe a case of a patient who presented with metastatic adenocarcinoma of the pancreas as cystic masses in the supraclavicular and axillary regions. Additionally, this patient was initially treated with FOLFIRINOX and continues to have stable primary and metastatic disease after 18 months from the diagnosis.

Keyword

Pancreatic cancer; Mucinous metastases; Mucinous pancreatic neoplasm

MeSH Terms

Adenocarcinoma*
Adenocarcinoma, Mucinous
Cystadenocarcinoma
Cystadenocarcinoma, Mucinous
Diagnosis
Disease-Free Survival
Fluorouracil
Humans
Mucins
Neoplasm Metastasis*
Pancreas*
Pancreatic Neoplasms
Prognosis
Survival Rate
Fluorouracil
Mucins