2017 Volume 32 Issue 2 Pages 178-184
An 81-year-old-man was admitted to our hospital for pancreatic tumors detected by abdominal ultrasonography. The patients underwent right nephrectomy for renal cell carcinoma (RCC) 26 years earlier. Abdominal dynamic computed tomography revealed multiple hyper vascular tumors in the pancreatic head and body. Based on the past history and imaging findings, we considered the tumors as pancreatic metastasis of RCC or pancreatic neuroendocrine tumor. To differentially diagnose the lesions, we performed ultrasound-guided fine needle aspiration (EUS-FNA) in the head of the pancreatic mass using a 25-gauge needle. Histological examination of the EUS-FNA specimens using the cell block method revealed metastatic renal cell carcinoma, and the histopathologic pattern of the EUS-FNA specimens was similar to that of the previous specimens of RCC diagnosed 26 years earlier.
Pancreatic metastasis from RCC is rare; however, it can occur many years after the initial diagnosis and treatment of the primary tumor. In the present case, EUS-FNA, using 25-gauge needle with the cell block method, was useful for the differential diagnosis of hyper vascular tumors of the pancreas.
