title: Spontaneous rupture of pancreatic metastasis from renal cell carcinoma.
abstract: We report the case of a 53-year-old female who was admitted for sudden abdominal pain. Her right kidney was resected in 1993 due to renal cell carcinoma. Abdominal computed tomography performed in September 2002, while she was placed under observation, revealed a tumor 40 mm in size that extended from the head to the body of the pancreas. Abdominal ultrasonography on admission indicated retention of ascites, and the aspirated ascites was bloody. Based on this result, spontaneous rupture of a pancreatic tumor was strongly suspected. On abdominal contrast-enhanced computed tomography, multiple tumors were clearly visualized in the pancreas. Angiography revealed high-density tumor in the early arterial phase. The results of endocrinological tests were normal. Accordingly, the patient was diagnosed with multiple pancreatic metastases of renal cell carcinoma, and total pancreatectomy was performed. Histopathologically, the tumor resected was clear cell carcinoma and corresponded to the renal cell carcinoma resected in 1993. This is a rare case of pancreatic metastasis of renal cell carcinoma that resulted in spontaneous rupture 9 years after nephrectomy.
authors.affiliation: Department of Medicine and Clinical Oncology, Graduate School of Medicine, Chiba University, Chuou-ku, Chiba 260-8670, Japan. konino@par.odn.ne.jp
authors.forename: Akitoshi
authors.initials: A
authors.lastname: Kobayashi
authors.forename: Taketo
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ishihara
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tadenuma
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Nakamura
authors.forename: Tadashi
authors.initials: T
authors.lastname: Ohshima
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Sakaue
authors.forename: Takeshi
authors.initials: T
authors.lastname: Baba
authors.forename: Masaharu
authors.initials: M
authors.lastname: Yoshikawa
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Saisho
mesh_terms: D000792:Angiography; D002292:Carcinoma, Renal Cell / Q000556:secondary* / Q000601:surgery; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D009392:Nephrectomy; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary* / Q000601:surgery*; D012422:Rupture, Spontaneous / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed