Kling Sarah M, Tannouri Sami, Jiang Wei, Yeo Charles J
Department of Surgery, Sidney Kimmel Medical College at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
J Pancreat Cancer. 2018 Aug 1;4(1):41-44. doi: 10.1089/pancan.2018.0001. eCollection 2018.
Metastases of renal cell carcinoma (RCC) to the pancreas are rare, whereas recurrence of pancreatic ductal adenocarcinoma (PDA) or a primary periampullary cancer is far more common. The time elapsed between a primary tumor and a new mass can aid in differentiation between the two. A 70-year-old man with a history of RCC status after left nephrectomy and ampullary adenocarcinoma status after pancreaticoduodenectomy presents with an incidentally found mass in his remnant pancreas. Resection of the mass via completion pancreatectomy yielded pathology consistent with metastatic RCC. Metastases of RCC to the pancreas often present many years after a primary resection. Conversely, recurrent PDA often presents within 5 years of resection. Resection of RCC metastases yields better survival than resection of recurrent PDA, which is controversial. We recommend resection of suspected isolated pancreatic RCC metastases due to known favorable outcomes.
肾细胞癌(RCC)转移至胰腺较为罕见,而胰腺导管腺癌(PDA)复发或原发性壶腹周围癌则更为常见。原发性肿瘤与新肿块之间的时间间隔有助于区分这两者。一名70岁男性,有左肾切除术后RCC病史及胰十二指肠切除术后壶腹腺癌病史,其残余胰腺偶然发现一个肿块。通过全胰腺切除术切除该肿块,病理结果与转移性RCC一致。RCC转移至胰腺通常在初次切除多年后出现。相反,复发性PDA通常在切除后5年内出现。切除RCC转移灶的生存率优于切除复发性PDA,这一点存在争议。鉴于已知的良好预后,我们建议切除疑似孤立性胰腺RCC转移灶。