Nervous system involvement by pancreatic cancer

From 1,229 consecutive patients with pancreatic cancer, seven patients who developed nervous system metastasis were evaluated retrospectively. Nervous system metastasis frequently antedated the diagnosis of the primary cancer ( five out of seven patients). Four patients had cerebral metastasis. Brain computed tomography or magnetic resonance imaging revealed single or multiple cyst-like lesions with ring enhancement in half of these patients. Three patients had spinal metastasis which caused myelopathy in two. The metastatic lesions were localized to the thoracic level. Radiation therapy directed to the metastatic sites could not change the clinical course.