Metastatic Renal Cell Carcinoma to the Pancreas: Diagnostic Significance of Fine-Needle Aspiration Cytology

Abstract

Background: Renal cell carcinoma rarely metastasizes to the pancreas. Diagnosing a neoplasm that is metastatic to the pancreas by fine-needle aspiration (FNA) cytology is often challenging. A detailed clinical history may prove to be beneficial. Case Reports: A total of 729 pancreatic FNAs were performed from January 2005 through August 2012 at our institution. Among these, we found 3 patients with a prior history of a malignant renal neoplasm who presented with a pancreatic mass: 2 in the tail and 1 in the head. Radiographically, they ranged in size from 2.5 to 7.0 cm. Microscopic evaluation of cytologic material obtained during endoscopic ultrasound-guided FNA (EUS-FNA) revealed cohesive clusters of atypical cells with clear cytoplasm and prominent nucleoli surrounded by a thin capillary network. The neoplastic cells were immunoreactive with CD10 (cases 2 and 3). A diagnosis of metastatic clear cell renal cell carcinoma was rendered for each case based on the morphologic features and immunohistochemical staining pattern of the neoplastic cells. Histologic comparison with the available slides of the corresponding primary renal neoplasm confirmed the diagnosis. Conclusion: We conclude that EUS-FNA of pancreatic masses is an important, effective, and accurate diagnostic modality for early diagnosis of both primary and metastatic neoplasms of the pancreas.

Synchronous renal cell carcinoma metastasis to the contralateral adrenal gland and pancreas: A case report with 7-year follow-up subsequent to surgical therapy

“…However, a larger pancreatic tumor may cause abdominal pain, jaundice and weight loss (18). In the present case, the pancreatic metastatic nodule was small and not detected during preoperative examination.…”

Diagnosis of Metastatic Renal Cell Carcinoma on Fine-Needle Aspiration Cytology

“…4 Although metastases to the pancreas are generally rare occurrences, RCC represents the most common primary etiology when metastatic tumors are encountered in the pancreas. [5][6][7][8][9][10] Similarly, metastases to the thyroid gland are uncommon; nonetheless, RCC represents the most commonly encountered metastatic tumor in thyroid FNAs. 11,12 Metastatic RCCs diagnosed in parotid gland FNAs have also been reported.…”

Cytology diagnosis of metastatic clear cell renal cell carcinoma, synchronous to pancreas, and metachronous to thyroid and contralateral adrenal: Report of a case and literature review

“…19 Malignancies are now followed with PET-CT for detection and further evaluation of new lesions as primary versus metastatic. [10][11][12][13][14] Typically metachronous, with latency period 10 years, 4,[9][10][11]13,14 and ranges from 5 months to 29 years 10 with longest reported as 36 years. [2][3][4][6][7][8]20 Pancreatic metastasis is uncommon in clinical studies 4.5%; nonetheless, 11% in autopsies.…”

“…[2][3][4][6][7][8]20 Pancreatic metastasis is uncommon in clinical studies 4.5%; nonetheless, 11% in autopsies. 4,9 Pancreatic mass was a first sign of metastasis in 16%. 4 Recent US-FNA series cited RCC as the most frequent primary.…”

“…4 Recent US-FNA series cited RCC as the most frequent primary. [9][10][11]14 EUS-FNA is effective for pancreatic metastasis diagnosis, with 89% diagnostic accuracy, and latter is improved by ROSE. 12 Usually solitary, with symptoms including gastrointestinal bleeding, abdominal pain, jaundice, weight loss, and/or chronic pancreatitis.…”