Comunoğlu Cem, Altaca Gülüm, Demiralay Ebru, Moray Gökhan
Department of Pathology, Başkent University Faculty of Medicine, Istanbul, Turkey.
Malays J Pathol. 2012 Jun;34(1):63-6.
Renal cell carcinoma (RCC) metastases to the pancreas are reported to be rare. Isolated multiple pancreatic metastases are even rarer. We report a 68-year-old asymptomatic male patient who presented with multiple metastatic nodular lesions in the pancreas demonstrated by computerized tomography 3.5 years after radical nephrectomy performed for clear cell RCC. Spleen-preserving total pancreatectomy was performed. Gross examination revealed five well-demarcated tumoral nodules in the head, body and tail of the pancreas. Histopathological examination revealed clusters of epithelial clear cells, immunohistochemically positive for CD10 and vimentin, and negative for CK19 and chromogranin, supporting a diagnosis of metastatic RCC. The patient has remained well at 29 months post-resection, in agreement with recent experience that radical resection for multiple isolated metastatic nodular lesions can achieve improved survival and better quality of life.
据报道,肾细胞癌(RCC)转移至胰腺的情况较为罕见。孤立性多发性胰腺转移更为罕见。我们报告一例68岁无症状男性患者,在因透明细胞RCC行根治性肾切除术后3.5年,计算机断层扫描显示胰腺出现多个转移性结节性病变。实施了保留脾脏的全胰切除术。大体检查发现胰腺头部、体部和尾部有五个边界清晰的肿瘤结节。组织病理学检查显示上皮透明细胞簇,免疫组化CD10和波形蛋白呈阳性,细胞角蛋白19和嗜铬粒蛋白呈阴性,支持转移性RCC的诊断。该患者术后29个月情况良好,这与近期经验相符,即对多个孤立性转移性结节性病变进行根治性切除可提高生存率并改善生活质量。