A 72-year-old man who had undergone left nephrectomy for a primary renal cell carcinoma 17 years earlier was admitted because of melena. He was found to have severe anemia on clinical examination. Ultrasonography, CT, MRI, and angiography showed a solid, hypervascular tumor, 6 cm in diameter, in the uncinate process of the pancreas. Active bleeding from the tumor was observed in the duodenum on upper gastrointestinal endoscopy. The diagnosis of pancreatic metastasis was based on the patient's past history and angiographic demonstration of typical hypervascular tumor staining, and the patient was successfully treated by emergency pylorus-preserving pancreaticoduodenectomy. Histologically, the tumor corresponded to renal cell carcinoma, and pancreatic metastasis of renal cell carcinoma was diagnosed. The patient is alive 7 months later, with no evidence of recurrence.
View full abstract