EUS-guided FNA of pancreatic metastasis from renal cell carcinoma

BACKGROUND: The prognosis for patients with renal cell carcinoma metastatic to the pancreas is better than that for patients with primary pancreatic adenocarcinoma. In patients with a history of renal cell cancer, it would, therefore, appear necessary to obtain cytologic or histopathologic evidence of the tumor type. EUS-guided FNA is considered the technique of choice for this purpose. This study retrospectively assessed the efficacy of EUS-guided FNA and specific technical considerations when the procedure is performed for this indication. METHODS: Over 2 years, EUS-guided FNA was performed in 11 consecutive patients with a history of renal cell carcinoma and a solid mass within the pancreas. OBSERVATIONS: After EUS-guided FNA yielded a negative result in two patients, the sampling technique was modified, namely short aspiration with low negative vacuum pressure. This resulted in the detection of metastases of renal cell cancer in the remaining 9 patients. There was no procedure-related complication. CONCLUSIONS: EUS-guided FNA is safe and accurate for the diagnosis of pancreatic metastases of renal cell carcinoma. However, effective sampling requires techniques that differ from those used for solid pancreatic masses.     

Partial pancreatic head resection for pancreatic metastasis from renal cell carcinoma

We report partial pancreatic head resection for pancreatic metastasis of renal cell carcinoma. A 71-year-old man was admitted to our hospital without any complaint. Contrast-enhanced computed tomographic showed a hypervascular tumor 1.5 cm in diameter in the head of the pancreas. We performed partial head resection preserving the duct of Wirsung and the duct of Santorini. He is presently alive and well without any evidence of recurrent disease 18 months after the operation. Isolated pancreatic metastasis of renal cell carcinoma enables surgeons to perform partial pancreatic head resection in selected cases.     

Imaging features of pancreatic metastasis from clear cell renal carcinoma

正Objective To explore the imaging diagnosis in pancreatic metastasis from clear cell renal carcinoma.Methods Twenty three patients with pancreatic metastasis from clear cell renal carcinoma confirmed by pathology were enrolled during 2007 to 2014,and their clinical sources,images and pathologic findings were reviewed.Twenty three patients underwent CT and 8 patients underwent     

Solitary pancreatic metastasis from renal carcinoma

We present the case of a 60-year-old man with a history of left radical nephrectomy due to Fuhrman nuclear grade II renal carcinoma 8 years previously. Abdominal computed tomography was performed due to a closed abdominal injury, revealing a solid, 4-cm hypervascular mass in the head of the pancreas. The suspected diagnosis was pancreatic metastasis from renal carcinoma. Cephalic duodenopancreatectomy was performed. The diagnosis was confirmed by histopathological analysis. At 23 months of follow-up, the patient remains disease free.     

Results of duodenopancreatectomy for solitary pancreatic metastasis from renal cell carcinoma

The pancreas is an uncommon site of metastasis from renal cell carcinoma. We present five patients with solitary pancreatic metastasis from renal cell carcinoma located in the head of the pancreas, treated by duodenopancreatectomy. There were no perioperative deaths. Mean survival was 48 months; three patients were alive at the end of the study (at 27, 46, and 88 months, respectively) and two patients died, at 13 and 70 months. The 3- and 5-year survival rates of our patients together with 22 previously reported patients were 86% and 68%, respectively. We advocate aggressive surgical treatment when the metastatic disease is limited to the pancreas.     

Pancreatic metastasis of renal cell carcinoma: report of three cases

INTRODUCTION: The pancreas is an uncommon site of metastasis from renal cell carcinoma. EXEGESIS: Three observations are described in this review which is aimed at reporting recent data on diagnosis, prognosis and therapeutic features of this kind of metastasis 0: The average space of time between nephrectomy and the diagnosis of the metastasis was 16 years. They have been fortuitously discovered in 2 cases, in patients who did not complain of any pancreatic symptom, during abdominal ultrasonography done for another reason. In the third case, pancreatic symptoms led to the diagnosis. Endoscopic ultrasonography (EUS) was useful to diagnose multiple lesions misdiagnosed on CT-scan or MRI imaging. EUS patterns are characteristic, but histological and cytological examinations of EUS-guided needle biopsies are difficult to study according to the hypervascularized character of these metastasis. CONCLUSION: The diagnosis of pancreatic metastasis must be suggested for patients suffering from a pancreatic mass with a previous medical history of late renal cell carcinoma. According to their hypervascularized character, the negativity of EUS-guided needle biopsies could strongly direct the diagnosis. When surgery is possible, the survival rate is better than in primary pancreatic adenocarcinoma and is even better than in pancreatic metastasis from other sites.     

Three cases of malignant lymphoma accompanied by renal cell carcinoma

Three cases of malignant lymphoma (ML) accompanied by renal cell carcinoma (RCC) are reported. From September 1997 through August 2000, we treated 85 patients with ML. Among these patients, three had accompanying RCC (clear cell type): case 1, a 57-yr-old man with gamma/delta-T cell lymphoma; case 2, a 25-yr-old man with Grade 3 follicular lymphoma; case 3, a 64-yr-old man with MALToma of the right orbit. Renal cell carcinoma is a relatively rare disease, but several reports have indicated that, for some reason, the incidence of concurrent RCC and ML is higher than expected. It is possible that the two malignancies share some common background factors, such as genetic mutation, immunological abnormality, or an immunomodulatory effect of the first tumor. The patient in case 2 was thought to have an abnormal immunological background from his medical history, which included bronchial asthma, idiopathic thrombocytopenic purpura, and mesangial proliferative glomerulonephritis (non-IgA type). Therefore the combination of ML and RCC in this patient may have been due to immunological impairment.     

Pancreatic metastasis of renal cell carcinoma

BACKGROUND: Renal cell carcinoma (RCC) is a common cancer, but pancreatic metastasis of RCC is unusual. Because of the rarity and peculiarity, pancreatic lesions from RCC me-tastasis were described mostly in case reports which highlight the importance of a systematic analysis of this clinical condi-tion.
DATA SOURCES: Data of 7 patients with pancreatic metasta-sis of RCC treated in the Peking Union Medical College Hospi-tal were extracted and 193 similar patients reported in the past 10 years from the literature were analyzed. Epidemiological, pathological and follow-up information were investigated. Po-tential prognostic factors were compared with corresponding data reported 10 years ago.
RESULTS: Multivariate Cox regression showed that asymp-tomatic metastasis and surgical procedure were independent factors associated with better survival. Compared with the data reported 10 years ago, follow-up of RCC patients has been emphasized in recent years, and atypical surgery is fre-quently used since it has similar effect as typical surgery on tumor resection while it is able to preserve more pancreatic function.
CONCLUSION: Surgical treatment should be an option as long as the pancreatic metastasis of RCC is resectable.     

Differentiation of a pancreatic metastasis of a renal cell carcinoma from a primary pancreatic carcinoma by echo-enhanced power doppler sonography

In a 70-year-old patient who had been treated for a renal cell carcinoma, a pancreatic mass was detected on CT scan. To differentiate a pancreatic metastasis of the renal cell carcinoma from a pancreatic carcinoma, an echo-enhanced power Doppler sonography was performed. The pancreatic mass demonstrated a strong echo enhancement, proving its hypervascularization. This behaviour favoured the diagnosis of a pancreatic metastasis of the renal cell carcinoma which was confirmed by histology. The principles and the role of echo-enhanced power Doppler sonography in the differential diagnosis between a primary pancreatic carcinoma and a metastasis of a renal carcinoma in the pancreas are discussed. We conclude that this technique can provide an important contribution to the diagnosis in this special instance. However, histology is the standard in the differential diagnosis of pancreatic tumours.     

胰腺多发转移性肾透明细胞癌1例报告

正1病例资料患者男性,57岁,因"发现胰腺占位性病变1个月"入院。既往20年前因肾癌行左肾切除术,术后病理提示透明细胞癌。入院查体:右侧腹部可见长约15 cm手术瘢痕,余无阳性体征。增强多排螺旋CT检查提示:右肾确如,胰腺形态正常,胰管未见明显扩张;胰头及胰体尾部见结节状稍低密度灶,大小约     

Cardiac metastasis from a renal cell carcinoma

A 59-year-old man developed an episode of syncope while he was driving. This resulted in a motor vehicle accident, and the patient sustained an open fracture of the left femur. Biopsy of the left femur fracture showed a metastastic renal cell carcinoma, and echocardiography revealed a right ventricular mass without contiguous vena caval or right atrial involvement. This is one of the few reported cases of renal cell carcinoma associated with syncope as an initial symptom.     

Pancreatic metastasis from renal cell carcinoma.

We report a case of renal cell carcinoma that metastasized to the pancreas 7 years after the initial excision. The primary and the metastatic tumors were histologically similar. Upper gastrointestinal bleeding was the leading symptom in the present case and the cause of the patient's death.     

A renal cell carcinoma with metastasis to the urinary bladder

We report the case of a renal cell carcinoma with solitary metastasis to the urinary bladder, occurring 3 years after radical nephrectomy in a 68-year-old patient. The cystoscopy revealed a solid and rounded bladder lesion with a fine footstalk. Transurethral resection was performed and the pathological diagnosis was of eosinophil cell and clear cell carcinoma. The patient also presented secondary lesions in under- and upper-diaphragmatic lymph node area, brain and lung; therefore, he received treatment with several systemic therapies (Sorafenib, Sutent, Everolimus, IFN-alpha, Oxaliplatin and Gemcitabine).     

Pancreatic metastasis from renal cell carcinoma: report of three resected cases and review of Japanese cases

Metastatic pancreatic tumors from renal cell carcinoma are clinically rare. We report three cases with pancreatic metastasis from renal cell carcinoma that occurred following nephrectomy for this disease. In all cases, dual-phase computed tomography following bolus injection of contrast material showed an identifiable enhancement pattern suggestive of the metastatic lesions from renal cell carcinoma. Pancreatectomy for these patients was performed and the postoperative course was favorable. These patients died 55 months, 79 months, and 134 months after surgery. Surgical resection is the recommended treatment and providing that all lesions can be removed, the patient outcome should be relatively good.