隐匿于众目睽睽之下：影像学检查无法发现的肾细胞癌胰腺和胃转移灶

Peregoy Madison B, Powell Charleston R, Goldkind Lawrence, Baird Dean, Sanford Jeffrey A

Internal Medicine, Walter Reed National Military Medical Center, Bethesda, USA.

Gastroenterology, Walter Reed National Military Medical Center, Bethesda, USA.

Cureus. 2024 Sep 25;16(9):e70211. doi: 10.7759/cureus.70211. eCollection 2024 Sep.

Renal cell carcinoma (RCC) is one of the most common origins of pancreatic metastases. Pancreatic spread of RCC is often found incidentally on surveillance imaging in asymptomatic patients. We present the case of a 49-year-old male with a history of RCC who presented with acute pancreatitis. Multiple imaging studies showed no pancreatic masses, but endoscopic ultrasound with fine needle biopsy and endoscopy showed RCC metastases to the pancreas and stomach, respectively. Pancreatic metastases should be suspected in patients with RCC who present with progressive abdominal pain and biliary obstruction despite negative imaging. Endoscopy is useful for their detection.

肾细胞癌（RCC）是胰腺转移瘤最常见的起源之一。RCC的胰腺转移通常在无症状患者的监测成像中偶然发现。我们报告一例49岁有RCC病史的男性患者，其表现为急性胰腺炎。多项影像学检查未发现胰腺肿块，但内镜超声引导下细针穿刺活检和内镜检查分别显示RCC转移至胰腺和胃。对于有RCC病史且出现进行性腹痛和胆道梗阻但影像学检查阴性的患者，应怀疑有胰腺转移。内镜检查有助于其检测。