Pancreatic Metastasis in a Case of Merkel Cell Carcinoma

Rare of the rare of the rare!
A patient with past history 3 years ago of surgical excision of the rare skin tumor "Merkel cell carcinoma" presented by two pancreatic body and tail masses, 3 and 2 cm in diameter. EUS FNB was done, proved by cytopathological examination and Immune staining to be "Metachronous metastasis" 3 years after excision of the primary tumor!!!
Merkel cell carcinoma is a "rare" tumor, "rarely" produce metachronous metastasis to the "rare" site of the pancreas. More common to produce synchronous metastasis to the lung and liver!
So rare of the rare of the rare!!!
There is also accidental discovery of common hepatic artery aneurysm and fusiform dilatation of the celiac axis, I think just association and no relation to the disease.