Pancreatic metastasis from cervical cancer: A case report and literature review

Cervical cancer metastasis to the pancreas is rare, and the clinical manifestations are variable and contingent upon the location of the metastasis. Consequently, certain patients may be overlooked due to the absence of overt clinical symptoms. Nevertheless, there is no universally accepted treatment protocol for such patients. The present report describes a case of a 64-year-old woman with stage IIIB cervical squamous cell carcinoma (International Federation of Gynecology and Obstetrics 2009) who received definitive chemoradiation in March 2018 [intensity modulated radiation therapy (IMRT) + weekly paclitaxel + brachytherapy]. After 6 years, pancreatic metastasis was confirmed by MRI/PET-CT and endoscopic ultrasonography-guided fine-needle aspiration biopsy. Between January and May 2024, the patient underwent six cycles of paclitaxel/carboplatin/bevacizumab/programmed cell death protein 1 inhibitor therapy followed by IMRT (45 Gy with 55 Gy boost). Post-treatment imaging revealed a partial response (lesion reduction from 45x30 mm to 32x20 mm). As of November 2024, the latest data indicated that the patient was disease-free on pembrolizumab maintenance. Furthermore, a systematic review of 14 related cases described in previous studies to analyze the characteristics of metastatic pancreatic cancer (mPC) is presented. In total, 14 publications were identified for systematic review. Among these patients, 7 had squamous cell carcinoma. The median age of the patients at the time of initial diagnosis was 49.8 years, and the mean interval between the identification of the primary tumor and metastasis was 46 months. Several clinical manifestations were observed depending on the site of metastasis. Endoscopic ultrasonography-guided fine-needle aspiration was revealed as one of the most effective methods for diagnosing mPC. In conclusion, there is currently no consensus regarding subsequent treatment plans. Pancreatic metastases originating from cervical cancer are infrequent and necessitate careful consideration along with individualized treatment approaches.