Ann Hepatobiliary Pancreat Surg.  2019 Aug;23(3):240-244. 10.14701/ahbps.2019.23.3.240.

The pancreas as a target of metastasis from renal cell carcinoma: Results of surgical treatment in a single institution

• Glinka J
• Sanchez Claria R
• Ardiles V
• de Santibañes E
• Pekolj J
• de Santibañes M
• Mazza O

• KMID: 2456021
• DOI: http://doi.org/10.14701/ahbps.2019.23.3.240

Abstract

BACKGROUNDS/AIMS
Metastasis in the pancreatic gland is infrequent, representing between 2-5% of the tumors that affect this organ. However, secondary lesions of clear cell renal carcinoma (CCRC) can occur mainly in this location and it is frequently the only site of dissemination. Treatment of choice is resection in surgically fit patients, as it has been shown that it improves the quality of life and prognosis substantially. We retrospectively reviewed the clinical data of patients with pancreatic resections for metastatic CCRC since there are no reports of the treatment modality of this singular entity in Argentina.
METHODS
Retrospective cohort analysis over a 10-year period including eight patients who underwent pancreatic resection for metastatic CCRC.
RESULTS
75% of patients were male with an average age of 65.5 years. The pancreatic surgery occurred at a median time of 9.2 years (1-24.8) from the renal operation. The pancreatic lesions were mostly solitary and asymptomatic. A pancreaticoduodenectomy (PD) was performed in 4 patients (50%). Distal pancreatectomy (DP) was performed in 3 patients (37.3%) and one patient (12.5%) underwent a total pancreaticoduodenectomy. All the patients presented a confirmatory biopsy of pancreatic metastasis of CCRC. Complications were recorded in 3 patients (42.85%). No intraoperative or postoperative mortality was registered. With a median follow-up of 45 months, three patients presented recurrence at 32, 46 and 51 months, respectively. Only one patient showed death due to recurrence at 7.8 month.
CONCLUSIONS
CCRC pancreatic metastases treated surgically have a low morbidity and mortality rate in high volume centers, showing excellent long-term survival.

Keyword

Clear renal cell carcinoma; Metastasis; Pancreas; Surgery

MeSH Terms

Argentina
Biopsy
Carcinoma, Renal Cell*
Cohort Studies
Follow-Up Studies
Humans
Male
Mortality
Neoplasm Metastasis*
Pancreas*
Pancreatectomy
Pancreaticoduodenectomy
Prognosis
Quality of Life
Recurrence
Retrospective Studies

Figure

• 

  Fig. 1 CT scan showing multiple metastases from CCRC in the head of the pancreas. Note the hypervascular features in the arterial phase (black arrow) and the dilatated common bile duct (white arrow).

• 

  Fig. 2 Tumor proliferation, consisting of atypical cells with large clear cytoplasm and pronounced vascular proliferation (left) next to normal pancreatic parenchyma (right). Hematoxilyn/Eosin stain ×100.

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