Asymptomatic esophageal squamous cell carcinoma masquerading as a rare primary pancreatic carcinoma. Diagnosis by percutaneous fine needle aspiration

An unusual case of asymptomatic squamous cell carcinoma of the esophagus metastatic to the pancreas, mimicking a rare primary pancreatic neoplasm, is reported. Percutaneous fine needle aspiration (FNA) biopsy of a pancreatic lesion showed squamous cell carcinoma, which in the pancreas is virtually always metastatic in origin. This prompted a search for an occult primary elsewhere, resulting in the discovery of an esophageal neoplasm, which in itself is one of the least likely sources of pancreatic metastases. FNA biopsy was thus a useful and accurate diagnostic tool in establishing the true nature of the pancreatic neoplasm, sparing the patient unnecessary pancreatic surgery, with its attendant morbidity and hospital costs.