Takeda Ryo, Shimomura Katsumi, Taniguchi Fumihiro, Hamada Satoshi, Konishi Tomoki, Soga Koji, Komatsu Shuhei, Ikeda Jun, Shioaki Yasuhiro
Division of Digestive Surgery, Japanese Red Cross Kyoto Daiichi Hospital.
Gan To Kagaku Ryoho. 2023 Jan;50(1):93-95.
We reported a case in which a pancreatic resection was performed for pancreatic metastasis of renal cell carcinoma 24 years after nephrectomy, and a residual pancreatectomy was performed 4 years later for residual pancreatic recurrence. The patient was a 72-year-old. In 1991, he underwent right nephrectomy for right renal cell carcinoma. During follow-up, in 2015, mass lesions were noted in the pancreatic tail and distal pancreatectomy was performed on suspicion of pancreatic neuroendocrine tumor(NET). Pathological examination diagnosed metastasis of renal cell carcinoma. In 2019, mass lesions were noted in the residual pancreas and total pancreatectomy was performed. Pathological examination diagnosed metastasis of renal cell carcinoma. There was 5 cases in Japan, including an our case, in which pancreatectomy was performed again after pancreatectomy for pancreatic metastasis of renal cancer, and the average time until the first pancreatic metastasis was pointed out was 11.8 years, and the average time until pancreatic recurrence was 9.4 years. Pancreatic metastasis of renal cell carcinoma shows heterochronic and multiple metastasis occurs, requiring long-team follow-up. When determining the extent of resection, it was suggested that the minimum number of repetitions necessary may lead to a long-term prognosis, taking into account the patient's age, background.
我们报告了一例患者，其在肾切除术后24年因肾细胞癌胰腺转移接受了胰腺切除术，4年后因胰腺残留复发又进行了残留胰腺切除术。患者为一名72岁男性。1991年，他因右肾细胞癌接受了右肾切除术。在随访期间，2015年发现胰尾有肿块病变，因怀疑胰腺神经内分泌肿瘤（NET）进行了远端胰腺切除术。病理检查诊断为肾细胞癌转移。2019年，残留胰腺发现肿块病变，遂进行了全胰腺切除术。病理检查诊断为肾细胞癌转移。在日本，包括我们的病例在内，有5例患者在因肾癌胰腺转移进行胰腺切除术后再次接受了胰腺切除术，首次发现胰腺转移的平均时间为11.8年，胰腺复发的平均时间为9.4年。肾细胞癌的胰腺转移表现为异时性，且会发生多处转移，需要长期随访。在确定切除范围时，建议在考虑患者年龄、背景的情况下，必要的最小重复次数可能会带来长期预后。
