[Pancreatic hypernephroma manifested by a duodenal hemorrhage].
Clear cell carcinoma are known to be disseminated in 40% of cases once diagnosis is made. We describe a patient presenting with a proximal gastrointestinal hemorrhage four years after nephrectomy for a left renal carcinoma. Investigations showed a solitary pancreatic mass and we performed cephalic duodenopancreatectomy which confirmed the presence of metastasis of the clear cell carcinoma. Gastrointestinal hemorrhage in cancer patients generally suggests delayed metastatic dissemination. Pancreatic localization is present in nearly 20% of metastatic renal carcinomas but it is the only site in less than 1% of cases. Evidence of lymphatic spread of renal tumor is sustained by our report. Attitudes concerning the step-by-step process of metastasis, growth pattern of renal cancer and the role of surgery are discussed.
Service de chirurgie, Hôpital de zone, Morges.
J M
JM
Calmes
A
A
Meyer
D000368:Aged; D002292:Carcinoma, Renal Cell / Q000150:complications / Q000556:secondary / Q000601:surgery*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000150:complications / Q000556:secondary / Q000601:surgery*; D014057:Tomography, X-Ray Computed