Renal cell carcinoma metastatic to the pancreas: A single-institution series and review of the literature

Objectives. To present a series of 5 patients with solitary metastatic rena l cell carcinoma (RCC) to the pancreas after radical nephrectomy at our ins titution and review the published reports of this rare event. Methods. A retrospective review of the records of 5 patients with histologi cally confirmed RCC metastatic to the pancreas after radical nephrectomy wa s performed. A total of 5 patients (4 men, 1 woman) with a median age of 56 years (range 54 to 68) underwent radical nephrectomy for primary RCC. The pathologic stage was Robson I (n = 3) or Robson III (n = 2), with a left-si ded tumor occurring in 3 patients and a right-sided tumor in 2 patients. Th e median interval from nephrectomy to the diagnosis of the pancreatic metas tasis was 12 years (range 4 to 15). All patients were symptomatic at presen tation, including weight loss (n = 3), abdominal pain (n = 3), early satiet y (n = 1), steatorrhea (n = 1), and/or hemosuccus pancreaticus (n = 1). Results. All pancreatic metastases were hypervascular on imaging studies, a nd surgical removal was accomplished by pancreaticoduodenectomy (n = 3), pa rtial pancreatectomy (n = 1), or subtotal pancreatectomy (n = 1). One patie nt died of disseminated disease 12 months after pancreatic resection. Two o ther patients had recurrences in the lung (n = 1) at 5 months or the pancre as/liver (n = 1) at 48 months. Both of these patients underwent a second re section and were disease free at 2 and 12 months afterward. The two remaini ng patients were disease free at 7 and 24 months after pancreatic resection . Conclusions. RCC is an unpredictable tumor that may demonstrate very late m etastases even from early-stage lesions. Aggressive surgical management of isolated pancreatic lesions offers a chance of long-term survival. UROLOGY 56: 211-215, 2000. (C) 2000, Elsevier Science Inc.