Chin Wenjie, Cao Linping, Liu Xi, Ye Yufu, Liu Yuanxing, Yu Jun, Zheng Shusen
Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China.
Key Lab of Combined Multi-Organ Transplantation, Ministry of Public Health, Hangzhou, 310003, China.
J Med Case Rep. 2020 Feb 26;14(1):36. doi: 10.1186/s13256-020-2355-6.
Synchronous renal cell carcinoma metastasizing to the pancreas and subcutaneous tissue is very rare. Unusual metastatic sites require attention during follow-up of renal cell carcinoma. It is extremely rare for renal cell carcinoma to metastasize to the pancreas; it is also very rare for it to metastasize to the subcutaneous tissue and extremely rare for it to synchronously metastasize to the pancreas and subcutaneous tissue almost a decade after radical nephrectomy. It is well known that most pancreatic tumors are primary pancreatic adenocarcinoma. However, the pancreas can also be an uncommon site for metastasis. We present a rare case of synchronous metastasis of renal cell carcinoma to the pancreas and subcutaneous tissue; we believe it to be only the second such case reported to date.
We describe a case of a 74-year-old Chinese man who was diagnosed with metastatic renal cell carcinoma to the pancreas and subcutaneous tissue at the same time, 10 years after left radical nephrectomy. He received distal pancreatectomy with spleen preservation plus resection of the subcutaneous tissue lesions on the left side of the anterior abdominal wall and right waist. Pathology showed that all resected metastatic tumors were of the clear cell type. The patient was seen in regular follow-up afterward.
Synchronous metastatic renal cell carcinoma to the pancreas and subcutaneous tissue is very rare, and it might occur after primary tumor resection. Patients must undergo lifelong monitoring and follow-up with regular examination so that any possible metastasis can be detected early. The optimal resection strategy should involve adequate resection margins and maximal tissue preservation of the pancreas, because renal cell carcinoma metastasizing to the pancreas and subcutaneous tissue has a good prognosis with long-term survival.
同步性肾细胞癌转移至胰腺和皮下组织极为罕见。在肾细胞癌的随访过程中，不常见的转移部位需要引起关注。肾细胞癌转移至胰腺极为罕见；转移至皮下组织也非常罕见，而在根治性肾切除术后近十年同步转移至胰腺和皮下组织则极其罕见。众所周知，大多数胰腺肿瘤是原发性胰腺腺癌。然而，胰腺也可能是一个不常见的转移部位。我们报告一例肾细胞癌同步转移至胰腺和皮下组织的罕见病例；我们认为这是迄今为止报道的第二例此类病例。
我们描述了一例74岁的中国男性患者，在左肾根治性切除术后10年，同时被诊断为肾细胞癌转移至胰腺和皮下组织。他接受了保留脾脏的远端胰腺切除术以及切除前腹壁左侧和右腰部的皮下组织病变。病理显示所有切除的转移瘤均为透明细胞型。患者随后接受定期随访。
肾细胞癌同步转移至胰腺和皮下组织非常罕见，且可能在原发肿瘤切除后发生。患者必须接受终身监测和定期检查随访，以便早期发现任何可能的转移。最佳的切除策略应包括足够的切缘以及最大程度地保留胰腺组织，因为肾细胞癌转移至胰腺和皮下组织预后良好，可长期存活。
