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Metastatic adenocarcinoma of the pancreas presents as metastasesto the axillary/supraclavicular region as the first sign of the disease
Ann Hepatobiliary Pancreat Surg 2017 Nov;21(4):247-51
Published online November 30, 2017
Copyright © 2017 Ann Hepatobiliary Pancreat Surg.

Blake A Stewart1, Abdul Adjei2, Xiaohong Zhang3, and Jacqueline C Oxenberg4

1Department of General Surgery, 2Department of Hematology/Oncology, 3Department of Pathology, 4Department of Surgical Oncology, Geisinger Wyoming Valley Medical Center, Wilkes-Barre, PA, USA
Received June 26, 2017; Revised August 13, 2017; Accepted August 13, 2017.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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. (Ann Hepatobiliary Pancreat Surg 2017;21:247-251)
Keywords : Pancreatic cancer; Mucinous metastases; Mucinous pancreatic neoplasm


February 2018, 22 (1)