Pancreatic Metastasis from Renal Cell Carcinoma with Intraportal Tumor Thrombus

Hiroshi Kawakami; Masaki Kuwatani; Hiroaki Yamato; Keisuke Shinada; Satoshi Hirano; Satoshi Kondo; Atsuya Yonemori; Yoshihiro Matsuno; Masahiro Asaka

doi:10.2169/internalmedicine.47.1418

CASE REPORTS

Pancreatic Metastasis from Renal Cell Carcinoma with Intraportal Tumor Thrombus

Hiroshi Kawakami, Masaki Kuwatani, Hiroaki Yamato, Keisuke Shinada, Satoshi Hirano, Satoshi Kondo, Atsuya Yonemori, Yoshihiro Matsuno, Masahiro Asaka

Author information

Hiroshi Kawakami
Department of Gastroenterology, Hokkaido University Graduate School of Medicine
Masaki Kuwatani
Department of Gastroenterology, Hokkaido University Graduate School of Medicine
Hiroaki Yamato
Department of Gastroenterology, Hokkaido University Graduate School of Medicine
Keisuke Shinada
Department of Gastroenterology, Hokkaido University Graduate School of Medicine
Satoshi Hirano
Department of Surgical Oncology, Hokkaido University Graduate School of Medicine
Satoshi Kondo
Department of Surgical Oncology, Hokkaido University Graduate School of Medicine
Atsuya Yonemori
Department of Surgical Pathology, Hokkaido University Hospital
Yoshihiro Matsuno
Department of Surgical Pathology, Hokkaido University Hospital
Masahiro Asaka
Department of Gastroenterology, Hokkaido University Graduate School of Medicine

Keywords: renal cell carcinoma, pancreatic metastasis, portal venous tumor thrombus, intraportal growth, endoscopic ultrasound-guided fine-needle aspiration biopsy

JOURNAL OPEN ACCESS

2008 Volume 47 Issue 22 Pages 1967-1970

DOI https://doi.org/10.2169/internalmedicine.47.1418

Details

Abstract

A 68-year-old woman with a history of renal cell carcinoma (RCC) resected curatively 12 years previously was admitted to our department for scrutiny of pancreatic tumors. Various imaging studies demonstrated heterogeneously well-enhanced masses in the head and tail of the pancreas. The well-enhanced mass in the head of the pancreas was connected with the tumor thrombus in the portal vein. To differentially diagnose the multiple pancreatic lesions, we performed endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNAB). Histopathologic findings of the EUS-FNAB specimens were similar to those of the renal clear cell carcinoma previously resected. The patient underwent a surgical operation with segmental resection of the portal vein with the preoperative diagnosis of RCC metastasis to the pancreas with intraportal growth. Histopathological examination of the resected specimen revealed that the masses in the pancreas were multiple pancreatic metastases with intraportal tumor thrombus of RCC. The pancreas is a rare target for metastasis. This is a rare case of pancreatic metastasis from RCC with intraportal extension, and is the first preoperatively definitely diagnosed case using EUS-FNAB.

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