Figure

2 Linear array EUS picture pancreatic hypoechoic solid mass with CBD dilation Figure 3 ERCP image displaying CBDS stricture (arrow), with CBD retrodilaton Pathology Azacitidine ic50 revealed the presence of adenocarcinoma with CA 125 expression at immunohistochemistry (Figure 4), compatible with ovarian pancreatic metastasis. Figure 4 Cytological picture of pancreatic FNA: A. Hematossilin Eosin (×40); B. immunohistochemestry (×40) with anti CA-125 The patient is currently receiving repeat chemotherapy with carboplatin and Inhibitors,research,lifescience,medical taxol and is now in stable conditions. Discussion Tumours metastasizing to the pancreas are unusual and published series are limited by few patients (3). Pancreatic metastases are quite rare, usually found incidentally, and are more commonly reported in patients with renal cell carcinoma, melanoma, lung, colon or breast cancer (4). Due to the

low incidence of pancreatic Inhibitors,research,lifescience,medical metastasis, most masses of the pancreas are assumed to be primary pancreatic neoplasms Inhibitors,research,lifescience,medical (5). Tissue diagnosis is imperative because imaging alone is incapable of differentiating metastases from primary pancreatic tumours. EUS-FNA allows cytodiagnosis and can have a decisive influence on the selection of appropriate therapeutic strategies (6). Therefore, a tissue biopsy should be always required particularly in patients with past medical history of neoplasia, to truly differentiate between primary and secondary tumours in order to avoid misdiagnosis and delay in possible treatment. Our case describes a

rare case of a metachronous Inhibitors,research,lifescience,medical pancreatic metastasis from an ovarian cancer occurred 8 years after the first diagnosis. There are only Inhibitors,research,lifescience,medical few case reports in the literature of ovarian adenocarcinoma metastsis to the pancreas (7,8) and to our knowledge this is the first description of one occurred 8 years after the first diagnosis. The patient presented with jaundice and imagine techniques revealed a pancreatic head lesion infiltrating the portal vein, initially assumed to be a primary pancreatic tumour. Because of the previous history of ovarian neoplasia, EUS-FNA of the pancreatic lesion was performed and positive immunohistochemestry with anti CA-125 revealed the presence of a pancreatic metastasis from ovarian cancer and specific chemotherapy with carboplatin and taxol secondly was therefore started. In conclusion, although rare, pancreatic metastasis is an important cause of focal pancreatic lesions. Tissue biopsy should be always obtained in order to differentiate primary from secondary pancreatic tumours and to rapidly direct a patient’s appropriate therapy, both in terms of chemotherapy and surgery. Acknowledgements Disclosure: The authors declare no conflict of interest.
Trastuzumab (Herceptin®, F.