Ann Hepatobiliary Pancreat Surg.  2017 Aug;21(3):176-179. 10.14701/ahbps.2017.21.3.176.

Pancreatic resection for renal cell carcinoma metastasis: a case review

• Ko S
• Yun S
• Kim S
• Kim TN
• Seo HI

• KMID: 2389997
• DOI: http://doi.org/10.14701/ahbps.2017.21.3.176

Abstract

Renal cell carcinoma (RCC) is the most common type of kidney malignancy. The pancreas is an infrequent site of metastasis in relation to any type of malignancy. However, RCC is one of the tumor types that most frequently metastasize to the pancreas. In this study, we report our experiences with two patients who underwent pancreatic resection for metastatic RCC tumors; of these two patients, one patient had a tumor was a metachronous pancreas-only tumor, and the other patient's tumor was synchronous with hematogenous lung metastasis. Following left-side pancreatic resection, the patients were administered tyrosine kinase inhibitors.

Keyword

Renal cell carcinoma; Metastasis; Pancreas

MeSH Terms

Carcinoma, Renal Cell*
Humans
Kidney
Lung
Neoplasm Metastasis*
Pancreas
Protein-Tyrosine Kinases
Protein-Tyrosine Kinases

Figure

• 

  Fig. 1 Transabdominal ultrasound shows a well-defined hypoechoic mass in the body of the pancreas (arrow) (A). T2-weighted magnetic resonance imaging (MRI) shows a well-defined mass with heterogeneous signal intensity in the body of the pancreas (arrow) (B).

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  Fig. 2 Macroscopic appearance of the resected specimen.

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  Fig. 3 Axial (A) and coronal (B) contrast-enhanced computed tomography scan images show a well-defined homogeneously enhanced mass in the tail of the pancreas (arrow). A heterogeneously enhanced mass with central necrosis was also detected in the right kidney (*), suggesting renal cell carcinoma.

Reference

1. Bassi C, Butturini G, Falconi M, Sargenti M, Mantovani W, Pederzoli P. High recurrence rate after atypical resection for pancreatic metastases from renal cell carcinoma. Br J Surg. 2003; 90:555–559. PMID: 12734861.

2. Strobel O, Hackert T, Hartwig W, Bergmann F, Hinz U, Wente MN, et al. Survival data justifies resection for pancreatic metastases. Ann Surg Oncol. 2009; 16:3340–3349. PMID: 19777190.

3. Ballarin R, Spaggiari M, Cautero N, De Ruvo N, Montalti R, Longo C, et al. Pancreatic metastases from renal cell carcinoma: the state of the art. World J Gastroenterol. 2011; 17:4747–4756. PMID: 22147975.

4. Thompson LD, Heffess CS. Renal cell carcinoma to the pancreas in surgical pathology material. Cancer. 2000; 89:1076–1088. PMID: 10964338.

5. Sellner F, Tykalsky N, De Santis M, Pont J, Klimpfinger M. Solitary and multiple isolated metastases of clear cell renal carcinoma to the pancreas: an indication for pancreatic surgery. Ann Surg Oncol. 2006; 13:75–85. PMID: 16372157.

6. Tanis PJ, van der Gaag NA, Busch OR, van Gulik TM, Gouma DJ. Systematic review of pancreatic surgery for metastatic renal cell carcinoma. Br J Surg. 2009; 96:579–592. PMID: 19434703.

7. Dong J, Cong L, Zhang TP, Zhao YP. Pancreatic metastasis of renal cell carcinoma. Hepatobiliary Pancreat Dis Int. 2016; 15:30–38. PMID: 26818541.

8. Mekhail TM, Abou-Jawde RM, Boumerhi G, Malhi S, Wood L, Elson P, et al. Validation and extension of the Memorial Sloan-Kettering prognostic factors model for survival in patients with previously untreated metastatic renal cell carcinoma. J Clin Oncol. 2005; 23:832–841. PMID: 15681528.

9. Santoni M, Conti A, Partelli S, Porta C, Sternberg CN, Procopio G, et al. Surgical resection does not improve survival in patients with renal metastases to the pancreas in the era of tyrosine kinase inhibitors. Ann Surg Oncol. 2015; 22:2094–2100. PMID: 25472645.

10. Grassi P, Verzoni E, Mariani L, De Braud F, Coppa J, Mazzaferro V, et al. Prognostic role of pancreatic metastases from renal cell carcinoma: results from an Italian center. Clin Genitourin Cancer. 2013; 11:484–488. PMID: 23791435.