Repeat pancreatic resection for metachronous pancreatic metastasis from renal cell carcinoma: A case report. (May 2022)

• Record Type: Journal Article
• Authors: Itamoto, Shingo; Abe, Tomoyuki; Oshita, Akihiko; Hanada, Keiji; Nakahara, Masahiro; Noriyuki, Toshio
• Is Part Of: International journal of surgery case reports. Volume 94(2022)
• Publication Date: 2022-05
• Subjects: Pancreatic metastasis -- Renal cancer -- Surgical resection; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2022.107022
• Languages: English
• ISSNs: 2210-2612

Abstract

Abstract: Background: Pancreatic metastasis (PM) from renal cell carcinoma (RCC) is relatively rare. Surgical resection of PM from RCC is considered as the first choice treatment for achieving long-term prognosis. Herein, we report a case of secondary multiple metastases from RCC to the remnant pancreas following pancreatectomy, with a review of the relevant literature. Presentation of case: A 69-year-old man who underwent left nephrectomy for RCC (T2N0M0, stage II) 12 years ago was referred to our hospital. Multiple metastases to the pancreatic head from RCC occurred 2 years after the primary surgery, for which pancreaticoduodenectomy was performed. Nine years after metastatic resection, multiple tumors of the remnant pancreas were detected on dynamic computed tomography (CT); all tumors showed strong enhancement in the early phase, which persisted into the late phase. The tumors were round, the maximum diameter of the tumor was 20 mm, and they were hyperintense on T2-weighted magnetic resonance imaging. Positron emission tomography-CT revealed slight fluorodeoxyglucose uptake in the tumor. Multiple PMs were diagnosed, and the remnant pancreas was completely resected. Two years later, the patient was alive and showed no recurrence. Conclusions: Surgical resection could provide long-term prognosis, even if secondary PM from RCC occurs metachronously. Long-term follow-up is recommended after primary resection, and vigilance regarding the occurrence of PM is needed. Highlights: Surgical resection for pancreatic metastasis from renal cell carcinoma is considered as the first choice treatment. We report a case of secondary multiple metastases from renal cell carcinoma to the remnant pancreas following pancreatectomy. Surgical resection could provide long-term prognosis even if secondary pancreatic metastasis is occurred metachronously.