A Case of Metastasis-Induced Acute Pancreatitis in Renal Cell Carcinoma

Toshimichi Asano, Kazuhiro Iwai, Kazuaki Hazama, Ryosuke Kawasaki and Seiji Mega

Department of Surgery, Oji General Hospital

A 56-year-old man admitted for upper abdominal pain and acute myocardia infarction in June 2006 underwent left kidney partial resection for renal cell carcinoma (RCC) in 1999 and partial lung resection for a tumor metastatic from RCC in 2005. Laboratory tests on admission showed serum amylase elevated to 1,883 IU/L. Abdominal contrast-enhanced CT showed a diffusely enlarged, heterogeneously enhanced pancreas with fluid collecting in the omental bursa and left pararenal space. Based on a diagnosis of severe acute pancreatitis, we undertook percutaneous coronary intervention, followed by continuous nafamostat mesilate and imipenem infusion from the celiac artery. After severe acute pancreatitis had been treated, the man was found in abdominal contrast-enhanced CT to have a well-enhanced, 3 cm pancreatic head tumor. Based on the above findings, we suspected pancreatic metastasis from RCC and conducted pancreatoduodenectomy and necrosectomy in August 2006. Pathological examination of the resected specimen showed clear cell carcinoma resembling previously resected RCC. The man remains in good health without recurrence 2 years after surgery. Severe acute pancreatitis caused by pancreatic metastasis from RCC is rare.

Key words
metastasis-induced acute pancreatitis, pancreatic metastasis, renal cell carcinoma

Reprint requests
Toshimichi Asano Department of Surgery, Oji General Hospital
3-4-8 Wakakusa-cho, Tomakomai, 053-8506 JAPAN

Accepted
April 22, 2009

To read the PDF file you will need Abobe Reader installed on your computer.