Brain metastases (BM) of pancreatic origin are extremely rare. We review the literature around BM of pancreatic origin and describe a 38-year-old woman who developed BM 10 months after pancreaticoduodenectomy for treatment of pancreatic adenocarcinoma. She underwent resection and fractionated stereotactic radiotherapy followed by re-resection and Gamma Knife radiosurgery (GKRS) when the lesion recurred. She then developed two new BM, and was treated with GKRS. The patient is alive without progression 38 months after her most recent GKRS.
Pancreatic ductal adenocarcinoma (PDAC) is an aggressive malignancy characterized by poor prognosis, with only 7% of patients alive at 5 years . Many patients have metastatic disease upon presentation, but brain metastases (BM) are rare. In one review of 1229 PDAC patients, only 4 (0.33%) developed BM . Such low prevalence may be partly attributable to poor survival leading to death before development of BM, or to lack of evaluation for BM because of poor prognoses.
Read the full article in CNS Oncology here.