title: Limited pancreatectomy for metastatic pancreatic tumors from renal cell carcinoma.
abstract: OBJECTIVE
  Metastasis of renal cell carcinoma (RCC) to distant organs occurs commonly, even after radical nephrectomy, but metastatic lesions are rarely detected in the pancreas. The present study aim was to improve the postoperative quality of life of a patient with pancreatic metastasis of RCC through limited resection of the pancreas.
  
  
  METHODS
  Since therapeutic modalities including chemotherapy or radiation are ineffective for metastatic tumors, surgical intervention is a treatment of choice in selected patients. In patients with multiple pancreatic metastases, however, near-total or total pancreatectomy may result in a lower quality of life postoperatively due to endocrine and exocrine pancreatic insufficiency.
  
  
  RESULTS
  We used limited resection of the pancreas combined with removal of the uncinate process and distal pancreatectomy for a 65-year-old woman with multifocal pancreatic metastases located in the uncinate process, body, and tail of the pancreas, which were detected 6 years after radical nephrectomy for RCC. This surgical procedure allowed preservation of about 40% of the pancreatic parenchyma, with complete excision of metastatic tumors in the pancreas.
  
  
  CONCLUSIONS
  The patient has had an excellent quality of life with well-preserved pancreatic function and no evidence of tumor recurrence for 31 months after pancreatic surgery.
authors.affiliation: Department of Surgery, Nagasaki University, Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan. a-kit@bg8.so-net.ne.jp
authors.forename: Amane
authors.initials: A
authors.lastname: Kitasato
authors.forename: Yoshitsugu
authors.initials: Y
authors.lastname: Tajima
authors.forename: Tamotsu
authors.initials: T
authors.lastname: Kuroki
authors.forename: Ryuji
authors.initials: R
authors.lastname: Tsutsumi
authors.forename: Noritsugu
authors.initials: N
authors.lastname: Tsuneoka
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Adachi
authors.forename: Takehiro
authors.initials: T
authors.lastname: Mishima
authors.forename: Takashi
authors.initials: T
authors.lastname: Kanematsu
mesh_terms: D000368:Aged; D002292:Carcinoma, Renal Cell / Q000556:secondary* / Q000601:surgery*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology* / Q000601:surgery; D009367:Neoplasm Staging; D009392:Nephrectomy; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000556:secondary* / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome