Renal cell carcinoma (RCC) often metastasizes to the pancreas long after surgery. A 79-year-old male, who had undergone left nephrectomy for RCC 30 years ago, visited us because a growing tumor had been found in the tail of his pancreas on computed tomography. The tumor exhibited stronger enhancement in the arterial phase than in the delayed phase. An endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) biopsy was performed, and the pathological diagnosis was clear cell carcinoma. Sunitinib was administered, and the tumor shrank. It is important to be aware that pancreatic metastasis from RCC can occur more than 30 years after surgery, and EUS-FNA is diagnostically useful in such cases.
