Asymptomatic Pancreatic Metastasis from Renal Cell Carcinoma Diagnosed 21 Years after Nephrectomy

Abstract

This report presents our experience with a case of pancreatic metastasis of renal cell carcinoma (RCC) at a long-term follow-up after nephrectomy. A 73-year-old man underwent nephrectomy for right RCC 21 years ago; computed tomography (CT) scanning on routine follow-up revealed a solid mass in the tail of the pancreas, and magnetic resonance imaging (MRI) showed some tumors in the head and tail of the pancreas. The patient was asymptomatic and allergic to contrast medium. Therefore we could not perform contrast CT/MRI for further examination to diagnose pancreatic tumors. We undertook endoscopic ultrasonography (EUS) and detected a hypervascular and low echoic mass; tumor tissues were obtained by EUS-guided fine-needle aspiration (EUS-FNA). Pathological diagnosis revealed pancreatic metastasis of clear cell RCC; this was similar to the pathological findings of tumor tissues initially obtained by nephrectomy. EUS-FNA was extremely useful for the definitive diagnosis of a rare type of pancreatic tumor.

Observations on Solitary Versus Multiple Isolated Pancreatic Metastases of Renal Cell Carcinoma: Another Indication of a Seed and Soil Mechanism?

“…Since out of 456 sufficiently documented cases (322 case reports and 134 cases in summaries), at least 174 cases (38.1%) were described where multiple metastases developed in the pancreas from the beginning (case reports: N = 127 [24,26,39,44,45,50,52,55,57,60,62,65,67,70,74,79,81,82,86,88,90,92,93,96,97,99,101,102,104,105,106,107,112,113,115,119,120,124,127,131,133,139,141,144,145,146,147,153,158,159,163,166,170,171,182,188,190]; summaries: N = 47 [149,152,155,168,172,175]), this allows for a comparative examination of the multiple with the singular cases.…”

“…Since the results in that regard were already previously presented in detail [24,25], the results updated with the new included cases [130,134,143,153,159,165,167,169,170,173,176,182,184,185,186,187,188,189,190,191,192,193,194] are listed here in the form of a summary.…”

Clear cell adenocarcinoma presenting as acute pancreatitis: A rare form of primary pancreatic malignancy

“…More specifically, her CT abdomen on admission demonstrated nil malignant abnormalities in the genitourinary tract. In addition to this, clear cell carcinoma of renal origin is usually positive for CD10, CAIX, and PAX8, and negative for CK7 [6][7][8]. The presented patient's immunohistochemical profile demonstrated positive staining for CK7 and negative PAX 8 staining, which was inconsistent with clear cell carcinoma of renal origin.…”

Metastatic Clear Cell Renal Cell Carcinoma to Pancreas and Distant Organs 24 Years After Radical Nephrectomy: A Case Report and Literature Review

“…Approximately 25% of all patients with RCC have distant metastases at diagnosis, and more than one-third of all patients will develop metastases after nephrectomy ( 2 ). Clear cell renal cell carcinoma (CCRCC) is the most common histopathological type of RCC, and it originates from the proximal tubular epithelial cells that can invade the renal sinus and extend to the renal vein ( 3 ). Consequently, vascular invasion by CCRCC is more common than other histopathological types of RCC.…”

“…Compared to metastases to the liver, lung, adrenal gland, bone, or brain, RCC metastases to the pancreas are rare and account for 1%–4% of all malignant pancreatic tumors ( 4 , 5 ). Clinically, imaging modalities that can effectively differentiate metastases from primary pancreatic tumors include enhanced computed tomography (CT), positron emission tomography (PET) associated with CT (PET/CT), magnetic resonance imaging, and endoscopic ultrasound-guided fine-needle aspiration biopsy ( 3 ). Here, we describe a case of CCRCC metastases to the pancreas and other distant organs 24 years after radical nephrectomy and review the relevant literature.…”