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Presented by Ralph Hruban, M.D. and prepared by Robert E LeBlanc, M.D.
Case 3: This adult patient presented with a large mass extending from the pancreas to the stomach.
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1. Question
Week 512: Case 3
This adult patient presented with a large mass extending from the pancreas to the stomach. A distal pancreatectomy and partial gastrectomy were performed.images/REL_ONE_3A.jpg
images/REL_ONE_3B.jpg
images/REL_ONE_3C.jpgCorrect
Answer: Metastatic melanoma
Histology: This cellular spindle cell neoplasm has a high mitotic rate. Occasional cells have single prominent nucleoli. An immunostain for S-100 protein was positive, and an immunostain for MITF was focally positive.
Discussion: While pancreatic cancer often metastasizes to other organs, metastases to the pancreas are uncommon. Tumors that commonly metastasize to the pancreas in autopsy series include lung cancer, breast cancer, melanoma, gastric cancer, colorectal cancer, renal cancer and ovarian. In clinical (surgical series), the most common primaries include renal, lung, breast, colon and melanoma.
Incorrect
Answer: Metastatic melanoma
Histology: This cellular spindle cell neoplasm has a high mitotic rate. Occasional cells have single prominent nucleoli. An immunostain for S-100 protein was positive, and an immunostain for MITF was focally positive.
Discussion: While pancreatic cancer often metastasizes to other organs, metastases to the pancreas are uncommon. Tumors that commonly metastasize to the pancreas in autopsy series include lung cancer, breast cancer, melanoma, gastric cancer, colorectal cancer, renal cancer and ovarian. In clinical (surgical series), the most common primaries include renal, lung, breast, colon and melanoma.
