Abstract
Background Brain metastases (BMs) derived from pancreatic adenocarcinoma (PAC) have an extremely
low incidence (0.1–0.4%) and are usually associated with a very poor prognosis. The
treatment strategy is palliative and includes conventional radiotherapy, stereotactic
radiosurgery, chemotherapy, and surgical resection.
Case Description A 39-year-old man with a history of PAC developed a systemic tumor relapse with intracranial
progression. Magnetic resonance imaging (MRI) documented a right rolandic, cortical,
and cystic lesion with leptomeningeal intrasulcular extension. The intraoperative
ultrasound (iUS) depicted a hyperechogenic area surrounding the anechogenic cystic
lesion and allowed us to obtain gross total resection of the tumor.
Conclusions To the best of our knowledge, we describe for the first time the iUS aspect of a
pancreatic BM. In this case the use of iUS allowed us to increase the extent of resection
and surgical safety, thus reducing the risk of new postoperative neurologic deficits.
Keywords
intraoperative ultrasound - pancreatic adenocarcinoma - metastasis - brain
