Octreotide Uptake in Intracranial Metastasis of Pancreatic Ductal Adenocarcinoma Origin in a Patient with a Prolonged Clinical Course

We describe a case with prolonged survival of 2 years in a female patient with pancreatic ductal adenocarcinoma who, at diagnosis, already had liver spread and eventually succumbed to brain metastases which scanned positive with [(111) In-DTPA] octreotide scintiscan (OctreoScan). Subsequently, the patient underwent a craniotomy for resection of the metastases, but her condition deteriorated. A chromogranin A stain was negative, showing that there was no neuroendocrinal component to the cerebral secondaries. In contrast, tumor labeling with a monoclonal antibody associated with a favorable prognosis in pancreatic neoplasms was positive. There is mounting evidence that somatostatin receptor status confers a relatively favorable prognosis in pancreatic adenocarcinoma, although OctreoScan-positive brain metastases have not been previously reported.