Giulia A. Zamboni MD, Presenter: Speaker, Guerbet SA

Maria Chiara Ambrosetti MD, Abstract Co-Author: Nothing to Disclose

Fabio Lombardo, Abstract Co-Author: Nothing to Disclose

Roberto Pozzi Mucelli, Abstract Co-Author: Nothing to Disclose

To assess if the different site of pancreatic adenocarcinoma is related to a different lobar distribution of metastases within the liver.

From all the patients who underwent MDCT for first staging of pancreatic adenocarcinoma, we selected 51 consecutive patients (26 Males, 25 Females; mean age 60 yrs) with pathologically-proven liver metastases. 23 patients had a tumor in the head (Group A) and 28 in the body-tail (Group B). We analyzed site, diameter and vessel invasion of the pancreatic adenocarcinoma and number of metastases in each lobe of the liver (divided by using Cantlie’s line). Total number of metastases was compared between the two groups with an unpaired t-test. Fisher’s test was used to compare the number of metastases in the two lobes.

As expected, because of the delayed clinical symptoms in patients with adenocarcinoma of the tail of the pancreas, the number of liver metastases at diagnosis was significantly higher in group B than in group A (p<0.05). The ratio of metastases in the right and left lobes was significantly higher for group A than for group B (6.5:1 vs 3.3:1; p=0.0018).

Although liver metastases are more numerous in the right than in the left lobe in both groups, there is a significant difference in the ratio of metastases between the right and the left lobes in the two groups of patients. This phenomenon can support the existence of a “fast track” to the left liver lobe when the carcinoma invades the splenic vein, and may help in detection of liver metastases.

Pancreatic tumor location appears to affect the lobar distribution of metastases within the liver, potentially aiding their early identification.

Zamboni, G, Ambrosetti, M, Lombardo, F, Pozzi Mucelli, R, Lobar Distribution of Liver Metastases from Pancreatic Carcinoma: Is there a 'Fast Track' from the Body-tail to the Left Liver Lobe?.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13044404.html