Piskorz Łukasz, Mitura Kryspin, Olejniczak Witold, Misiak Piotr, Jablonski Slawomir
Department of General Surgery, Brothers of St John of God Hospital, Lodz, Poland.
Department of General Surgery, Siedlce Hospital, Siedlce, Poland.
Res Rep Urol. 2021 Jan 14;13:17-24. doi: 10.2147/RRU.S290150. eCollection 2021.
Pancreatic tumors account for a small percentage of all malignancies. Most of them are primary and originate from cells of the exocrine pancreas. The remaining primary changes are neuroendocrine tumors. The pancreas may also be a target of metastatic lesions. The most common cancer that metastasizes to the pancreas is renal cell carcinoma.
The paper presents two cases of rare metastases to organs of the abdominal cavity: the first patient treated surgically due to two metastatic lesions of renal cell carcinoma in the pancreas, diagnosed many years after radical nephrectomy. The second case of high gastrointestinal obstruction in the course of metastasis of renal cell carcinoma to the duodenum. The first patient underwent distal laparotomic resection of the pancreas. The second patient underwent resection of the duodenum and the first jejunal loop with side-to-side duodeno-jejunal anastomosis. Both patients remain under oncological supervision.
Patients after radical nephrectomy due to renal cell carcinoma require long-term systematic monitoring. Due to the anatomical position of the pancreas and duodenum as well as the number, location and size of metastatic lesions, the course of the disease may be initially asymptomatic or oligosymptomatic. Aggressive surgical treatment of pancreatic metastases creates opportunities for long-term survival.
胰腺肿瘤在所有恶性肿瘤中占比很小。其中大多数是原发性的，起源于外分泌胰腺细胞。其余的原发性病变是神经内分泌肿瘤。胰腺也可能是转移性病变的靶器官。最常见转移至胰腺的癌症是肾细胞癌。
本文介绍了两例罕见的腹腔器官转移病例：第一例患者因胰腺存在两个肾细胞癌转移病灶而接受手术治疗，这些病灶在根治性肾切除术后多年才被诊断出来。第二例是肾细胞癌转移至十二指肠导致高位胃肠道梗阻。第一例患者接受了胰腺远端剖腹切除术。第二例患者接受了十二指肠及第一空肠袢切除，并进行了十二指肠-空肠侧侧吻合术。两名患者均处于肿瘤学监测之下。
因肾细胞癌接受根治性肾切除术后的患者需要长期系统监测。由于胰腺和十二指肠的解剖位置以及转移病灶的数量、位置和大小，疾病进程最初可能无症状或症状轻微。积极的胰腺转移瘤手术治疗为长期生存创造了机会。
