A Resected Case of Total Pancreatectomy with Metachronous Multiple Metastasis to Pancreas of Renal Cell Carcinoma

Hiroaki Tsumura, Takashi Kodama, Takashi Yokoyama*, Yoshio Takesue, Yoshiaki Murakami, Naokuni Tatsumoto, Shinji Akagi, Yuichiro Matsuura

First Department of Surgery, School of Medicine, Hiroshima University
*Department of General Medicine, Hiroshima University Hospital

A case of renal cell carcinoma with metachronous multiple metastasis to the pancreas in a 57-year-old male is reported. He had received right partial nephrectomy 9 years earlier because of renal cell carcinoma, and multiple tumors of the pancreas were found by follow-up ultrasonography. Tumors with an unclear margin were detected in the whole pancreas by enhanced computed tomography. Tumors were detected iso intensity by T1 enhanced MRI study and heterogenous high intensity by T2 enhanced study. DSA study showed tumor stains and hypervascularity in the A-V shunt in the early period. ERP revealed multiple stenosis and occlusion of the main pancreatic duct. Tumor cells sampled by brushing of the main pancreatic duct were found to be class 2 by cytological diagnosis, and were dyed with p53. Consequently, endogenously derived tumors were neglected. Under the diagnosis of metastatic renal cell carcinoma to the pancreas, total pancreatectomy with D1 resection was performed. In this paper, we discuss about metastatic renal ce1l carcinoma to the pancreas reported in the literature.

Key words
renal cell carcinoma, matastatic pancreatic cancer

Reprint requests
Hiroaki Tsumura First Department of Surgery, School of Medicine, Hiroshima University
1-2-3 Kasumi-cho, Minami-ku, Hiroshima-city, 734 JAPAN

Accepted
May 21, 1997

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