Pancreatic metastases may occur from breast, lung and gastrointestinal tract primary tumours. They are relatively uncommon on ultrasound (Fig. below),
simply because they are a late manifestation in patients who already have known, widespread disease and in whom investigations are generally considered
unnecessary. Widespread metastatic disease can be demonstrated on ultrasound, particularly in the liver, and there is often considerable epigastric lymphadenopathy, which can be confused with the appearances of pancreatic metastases on the scan.
Pathology of the pancreas, both benign and malignant, can affect the adjacent vasculature by compression, encasement or thrombosis.
Doppler of the splenic, portal and superior mesenteric veins is useful in demonstrating the extent of vascular complication when pancreatic abnormalities are suspected
Ultrasound images Metastatic deposit from primary breast
carcinoma in the body of the pancreas (arrow).