腎細胞癌術後16年目に膵転移をきたした1例

Abstract

A 66-year-old woman was admitted to our hospital because of a pancreatic tumor detected by ultrasonography. She had undergone left nephrectomy for renal cell carcinoma (RCC) 16 years before. Abdominal CT and angiography showed hypervascular two masses in the head and tail of the pancreas，about 25mm and 10mm in size， respectively，suggesting primary neuroendocrine tumors of the pancreas. Under a diagnosis of primary neuroendocrine tumors of the pancreas，pancreatoduodenectomy and distal pancreatectomy were performed. Careful histological examination of the resected specimen revealed metastatic tumors from RCC, which were diagnosed as the clear cell type. Metastatic carcinoma to the pancreas is uncommon. Pancreatic metastasis from an RCC is exceptional，but may occur many years after the initial diagnosis and treatment of the primary tumor. Surgical therapy in patients whose metastatic pancreatic lesions are amenable to resection results in better palliation and improved survival. The result suggests the need for aggressive surgery for this type of carcinoma. The histologic analysis of pancreatic masses in patients with a history of resected primary RCC is important，because neuroendocrine carcinoma most closely resembles metastatic RCC on CT images.