Pylorus-preserving total pancreatectomy for metastatic renal cell carcinoma: a case report

Journal of Medical Case Reports

Masanori Kon¹  Yoichi Matsui¹  Sohei Satoi¹  Kazuhiko Yoshioka¹  Takashi Matsuura¹  Masanori Yamada¹  Hidesuke Yanagida¹  Hiroaki Kitade¹ 

[1] Department of Surgery, Kansai Medical University, 2-5-1 Shin-machi, Hirakata 573-1191, Osaka, Japan

关键词: Renal cell carcinoma;    Pylorus-preserving total pancreatectomy;    Pancreas;    Metastasis;   

Others  :  1231241
DOI  :  10.1186/s13256-015-0654-0

 received in 2014-11-29, accepted in 2015-07-13,  发布年份 2015

【 摘 要 】

Introduction

Resectable isolated multiple metastases to the pancreas from renal cell carcinoma are rare. In this report, we describe a patient with multiple metastases of renal cell carcinoma to the pancreas who was treated with pylorus-preserving total pancreatectomy.

Case presentation

The patient was a 58-year-old Asian woman who had undergone right nephrectomy for renal cell carcinoma 20 years earlier. In 2008, she was diagnosed with multiple metastases of renal cell carcinoma to the pancreas by abdominal computed tomography during routine follow-up for renal cell carcinoma.¹⁸ F-2-fluoro-2-deoxyglucose positron emission tomography/computed tomography showed no accumulation in her body other than the pancreas. Because of concerns about her quality of life after total pancreatectomy, she underwent pylorus-preserving total pancreatectomy. After the resection, her control of blood sugar and quality of life were generally satisfactory. She died as a result of gastrointestinal bleeding 35 months after undergoing pancreatectomy.

Conclusions

Pancreatic metastasectomy should be considered, even for multiple metastases, when the primary tumor is renal cell carcinoma and the metastatic lesions are isolated.

【 授权许可】

   
2015 Kitade et al.

【 图 表 】

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【 参考文献 】

• [1]Konstantinidis IT, Dursun A, Zheng H, Wargo JA, Thayer SP, Fernandez-del Castillo C et al.. Metastatic tumors in the pancreas in the modern era. J Am Coll Surg. 2010; 211:749-53.
• [2]Reddy S, Edil BH, Cameron JL, Pawlik TM, Herman JM, Gilson MM et al.. Pancreatic resection of isolated metastases from nonpancreatic primary cancers. Ann Surg Oncol. 2008; 15:3199-206.
• [3]Reddy S, Wolfgang CL. The role of surgery in the management of isolated metastases to the pancreas. Lancet Oncol. 2009; 10:287-93.
• [4]Sweeney AD, Wu MF, Hilsenbeck SG, Brunicardi FC, Fisher WE. Value of pancreatic resection for cancer metastatic to the pancreas. J Surg Res. 2009; 156:189-98.
• [5]Zerbi A, Ortolano E, Balzano G, Borri A, Beneduce AA, Di Carlo V. Pancreatic metastasis from renal cell carcinoma: which patients benefit from surgical resection? Ann Surg Oncol. 2008; 15:1161-8.
• [6]Palmowski M, Hacke N, Satzl S, Klauss M, Wente MN, Neukamm M et al.. Metastasis to the pancreas: characterization by morphology and contrast enhancement features on CT and MRI. Pancreatology. 2008; 8:199-203.
• [7]Müller MW, Friess H, Kleeff J, Dahmen R, Wagner M, Hinz U et al.. Is there still a role for total pancreatectomy? Ann Surg. 2007; 246:966-74.
• [8]Casadei R, Monari F, Buscemi S, Laterza M, Ricci C, Rega D et al.. Total pancreatectomy: indications, operative technique, and results: a single centre experience and review of literature. Updates Surg. 2010; 62:41-6.
• [9]Sellner F, Tykalsky N, De Santis M, Pont J, Klimpfinger M. Solitary and multiple isolated metastases of clear cell renal carcinoma to the pancreas. Ann Surg Oncol. 2006; 13:75-85.
• [10]Sugiyama M, Atomi Y. Pylorus-preserving total pancreatectomy for pancreatic cancer. World J Surg. 2000; 24:66-71.
• [11]Akatsu T, Shimazu M, Aiura K, Ito Y, Shinoda M, Kawachi S et al.. Clinicopathological features and surgical outcome of isolated metastasis of renal cell carcinoma. Hepatogastroenterology. 2007; 54:1836-40.
• [12]Comunoğlu C, Altaca G, Demiralay E, Moray G. Multiple metastatic renal cell carcinoma isolated to pancreas. Malays J Pathol. 2012; 34:63-6.
• [13]Hatori T, Kimijima A, Fujita I, Furukawa T, Yamamoto M. Duodenum-preserving total pancreatectomy for pancreatic neoplasms. J Hepatobiliary Pancreat Sci. 2010; 17:824-30.