[Multiple metachronous metastases of renal cell carcinoma in the pancreas. Case report and review of the literature].
Isolated pancreatic metastases from renal-cell carcinomas (RCC) are extremely rare. Only 96 cases of clinically diagnosed renal-cell carcinoma metastatic to the pancreas have been reported in the world literature, and 70 of the patients (including ours) underwent a definitive surgical resection. In many cases the time between the nephrectomy and diagnosis of metachronous metastases is reported to exceed 10 years. Therefore, the initial diagnosis may be overlooked when there is a prolonged disease-free interval. When it does occur simultaneously or metachronously, aggressive surgical resection, when possible, seems to be the most effective treatment for this metastatic lesion. Surgical resection can provide long-term survival in selected cases. We present the case of a 69-year-old woman in whom two pancreatic metastases were treated by a left-sided subtotal pancreatectomy with splenectomy, 12 years after radical nephrectomy for a RCC. The patient simultaneously presented with both a mass in the body of the pancreas and a right-sided colon cancer. Thus, the diagnosis of pancreatic metastasis of colon cancer was suspected initially. Both tumors were radically resected, and histological examination revealed two pancreatic metastases from the previous RCC. In the world literature this report represents the eighth case of multiple pancreatic metastases due to RCC. It illustrates a rare indication of pancreatic resection because of pancreatic metastasis. The need for prolonged follow-up of patients is emphasized. The few reports on surgically treated pancreatic metastases from RCC are reviewed after the presentation of this case.
Fricke
P
P
Klinik für Chirurgie, Otto-von-Guericke-Universität Magdeburg.
Schulz
H U
HU
Buhtz
P
P
Lippert
H
H
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D002430:Cecal Neoplasms / Q000473:pathology / Q000601:surgery*; D002432:Cecum / Q000473:pathology / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007668:Kidney / Q000473:pathology; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D016609:Neoplasms, Second Primary / Q000473:pathology / Q000601:surgery*; D009392:Nephrectomy; D010179:Pancreas / Q000473:pathology; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D012086:Reoperation; D013156:Splenectomy
Multiple metachrone Metastasen eines Nierenzellcarcinoms im Pankreas. Fallbeschreibung und Literaturübersicht.