2020 Volume 45 Issue 4 Pages 384-391
The patient was a 77-year-old female patient who had undergone nephrectomy for right renal cell carcinoma 13 years ago. She presented to us with nausea, and CT showed two hypervascular tumors in the pancreas measuring 40 mm and 9 mm in diameter. The tumor measuring 40 mm in diameter showed a heterogeneous area within it, which was assumed to represent an area of necrosis. On MRI, the tumors were visualized as low-intensity areas on T1WI and as high-intensity areas on T2WI, and had capsule-like structures. There was no evidence of any other metastatic lesions. Based on the history and imaging findings, we suspected the tumors as being pancreatic metastases from renal cell carcinoma. Distal pancreatectomy with splenectomy was performed, considering her age and QOL. After the surgery, the patient developed a pancreatic fistula, ISGPF grade A, and remnant pancreatitis, but she could be discharged from the hospital after 30 days. We finally diagnosed the patient as a case of pancreatic metastasis from renal cell carcinoma, because the histopathological findings showed that the tumor was composed clear cells. In addition to the lesions detected in the preoperative images, histopathological examination revealed another micro metastasis measuring 2 mm in diameter. Pancreatic metastasis from renal cell carcinoma is rare. We encountered a case of renal cell carcinoma who presented with pancreatic metastatic tumors 13 years after nephrectomy, and report our case herein, along with the relevant literature.
