title: [A Case of Multiple Pancreatic Metastases from Renal Cell Carcinoma Diagnosed Using EUS-FNA].
abstract: The patient was a 79-year-old man, who underwent left nephrectomy for left renal cell carcinoma in 2007. In March 2015, he complained ofthirst, polydipsia, and polyuria. A slight elevation ofamylase levels was detected following laboratory testing. Abdominal CT revealed well-enhanced tumors in the pancreatic head and tail. MPD was dilated in the pancreatic body and tail. Endoscopic ultrasound-guided fine-needle aspiration(EUS-FNA)was used to obtain additional pathological findings. We diagnosed multiple pancreatic metastases from renal cell carcinoma using cell block sections from EUS-FNA ofthe pancreatic head tumor. We also identified worsening of diabetes control due to pancreatic disease. A subtotal stomachsparing pancreaticoduodenectomy and a distal pancreatectomy were performed in June 2015. Histological examination confirmed clear cell carcinoma metastases from RCC in both tumors. The patient remains alive without recurrence approximately 1 year after surgery. Glycemic control has improved with a decrease in insulin levels. Cell block sections from EUS-FNA are useful in the diagnosis of pancreatic disease. Although postoperative follow-up ofthe remnant pancreas is important, preservation ofthe pancreas should be considered for multiple pancreatic metastases when complete tumor removal is possible.
authors.affiliation: Dept. of Surgery, Osaka Rosai Hospital.
authors.forename: Chikato
authors.initials: C
authors.lastname: Koga
authors.forename: Masahiro
authors.initials: M
authors.lastname: Murakami
authors.forename: Junzo
authors.initials: J
authors.lastname: Shimizu
authors.forename: Akinobu
authors.initials: A
authors.lastname: Yasuyama
authors.forename: Tae
authors.initials: T
authors.lastname: Matsumura
authors.forename: Chizu
authors.initials: C
authors.lastname: Kameda
authors.forename: Ryohei
authors.initials: R
authors.lastname: Kawabata
authors.forename: Naofumi
authors.initials: N
authors.lastname: Oda
authors.forename: Masaki
authors.initials: M
authors.lastname: Hirota
authors.forename: Masato
authors.initials: M
authors.lastname: Yoshikawa
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Morishima
authors.forename: Shingo
authors.initials: S
authors.lastname: Noura
authors.forename: Nobuki
authors.initials: N
authors.lastname: Matsunami
authors.forename: Junichi
authors.initials: J
authors.lastname: Hasegawa
mesh_terms: D000368:Aged; D002292:Carcinoma, Renal Cell / Q000556:secondary* / Q000601:surgery; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology* / Q000601:surgery; D008297:Male; D009392:Nephrectomy; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary* / Q000601:surgery; D016577:Pancreaticoduodenectomy