A Case of Multiple Pancreatic Metastases from Renal Cell Carcinoma Treated by Total Pancreatectomy

Kazuhide Iwakawa, Yasushi Matsumoto, Jyota Watanabe, Yoshito Ono, Yasuyuki Shimahara, Nobuaki Kobayashi

First Department of Surgery, Ehime University School of Medicine

Renal cell carcinoma commonly matastasizes to the lung, bone and liver. However, metastasis to the pancreas is rare and often multiple, so diagnosis and treatment are difficult. We report a case of multiple pancreatic metastases from renal cell carcinoma 4 years after nephrectomy and resection of metastases to the brain and thyroid. A 52-year-old woman was admitted to our hospital with the chief complaint of bloody stool. Barium enema and colon fiberscopy revealed a tumor at the sigmoid colon. Abdominal CT and angiography demonstrated multiple hypervascular tumor at the pancreatic head and tail. Total pancreatectomy and sigmoidectomy were performed under the diagnosis of metastatic pancreatic tumor and carcinoma of the sigmoid colon. Histological examination confirmed it to be clear cell type renal cell carcinoma that had metastasized to the pancreas. Chemotherapy and radiation are not effective, and therefore, total pancreatectomy, when possible, could be the most useful treatment for this metastatic lesion.

Key words
renal cell carcinoma, multiple pancreatic metastases

Reprint requests
Kazuhide Iwakawa First Department of Surgery, Ehime University School of Medicine
Shitzukawa, Onsen-gun, Shigenobu-cho, Ehime, 791-02 JAPAN

Accepted
June 12, 1996

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