A case of pancreatic metastasis from renal cell carcinoma presenting as gastrointestinal hemorrhage

Abstract

A 58-year-old man who had undergone right partial nephrectomy for right renal cell carcinoma (RCC) thirteen years ago went to the nearest hospital because of tarry stool. Due to the severe anemia (Hb 5.4mg/dl), an upper GI series was performed and revealed bleeding from the ulcer of a Type II tumor in the second portion of duodenum. Bleeding was clipped and an enhanced-CT showed four hypervascular tumors in the pancreatic head. It was diagnosed as duodenal invasion of metastatic pancreatic tumors from RCC, and pancreaticoduodenectomy was performed. Microscopic examination of the resected pancreas showed clear cell carcinoma compatible with metastasis from RCC. Cases of pancreatic metastases from RCC have been reported. A search of the literature yielded nine cases of hemorrhage caused by pancreatic metastases from RCC. Surgical resection should be firstly selected for gastrointestinal bleeding due to pancreatic metastasis from RCC.