Renal cell carcinoma to the pancreas in surgical pathology material - A clinicopathologic study of 21 cases with a review of the literature

BACKGROUND. Clear cell carcinomas of the pancreas are rare and more likely represent metastatic renal cell carcinoma (RCC). METHODS. Twenty-one cases of metastatic RCC to the pancreas were retrieved from the files of the Endocrine Registry of the Armed Forces Institute of P athology. Histologic features were reviewed, special stains and immunohisto chemical studies were performed, and patient follow-up data were obtained. RESULTS, The patients included 9 women and 12 men ages 47-76 years (mean, 6 4.4 years). Patients experienced weight loss, abdominal pain, or a mass les ion. The tumors occurred anywhere within the pancreas. The mean size of the tumors was 4.0 cm. Histologically, the tumors were comprised of clear cell s with a rich vascular network The RCC was diagnosed before (n = 17 patient s; ages up to 32.7 years) or after (n = 4 patients; ages up to 13.2 years) the pancreatic metastases were discovered. Surgery was used in all patients . Adjuvant chemotherapy was used in 4 patients. From the date of the diagno sis of pancreatic metastasis, 13 patients were dead with disseminated disea se (DD) [mean, 4.5 years), and 8 patients were without disease (mean, 9.0 4 ears). From the date of the diagnosis of primary RCC, 13 patients were DD (mean, 12.7 years], and 8 patients were without disease (mean, 24.7 years). CONCLUSIONS. Although histochemical and immunohistochemical studies may hel p in the distinction between patients with primary Versus metastatic clear cell tumors of the pancreas, clinical confirmation should be obtained. Surg ical resection of the pancreatic metastatic disease is suggested, because t he patient may still have a prolonged survival. Cancer Published 2000 by th e American Cancer Society.*.