Abstract
PurposeThis study aimed to determine the outcome of pancreatic metastatic renal cell carcinoma (PmRCC) after treatment and share the relevent results.MethodsIn total, 13 patients with PmRCC were diagnosed and treated in our institution from December 2013 to October 2017. We retrospectively reviewed the records and analyzed the patient demographics, perioperative outcomes, and overall survival. Simultaneously, our experience including treatment and misdiagnosis was shared.ResultsThe median time between nephrectomy and reoperation for pancreatic recurrence was 11 years (range 1–20 years). Four patients had multiple tumors and nine patients had solitary tumor. Five patients accepted distal pancreatectomy, and five patients underwent pancreaticoduodenectomy. One patient underwent total pancreatectomy, one patient underwent duodenum-preserving pancreatic head resection plus distal pancreatectomy, and one patient underwent exploratory laparotomy and gastrointestinal bypass due to widespread metastasis with clear obstructive symptoms. The misdiagnosis rate of preoperative diagnosis at our center was 69.2% (9/13). The median follow-up duration was 26 months (range 7–53 months, until June 2018). By the end of follow-up, 12 patients were alive and one patient died of gastrointestinal bleeding within 1 month after surgery.ConclusionsPmRCCs are uncommon, but pancreatic metastasectomy has a relatively good prognosis and may, therefore, be a good therapeutic choice for patients with PmRCCs. Because PmRCC occurs long after the primary tumor resection, long-term follow-up is necessary. Besides, detailed medical history and specific manifestation in imaging features could contribute to avoiding misdiagnosis.
Highlights
The prevalence of renal cell carcinoma (RCC) is an increasing cause of mortality in USA and has accounted for 14,970 deaths in 2018 [1]
pancreatic metastatic renal cell carcinoma (PmRCC) often occurs a long time after nephrectomy, which makes them difficult to detect [7,8,9,10]
For the metastasis of RCC, the detection and diagnosis mainly depend on the medical history and pathology results
Summary
The prevalence of renal cell carcinoma (RCC) is an increasing cause of mortality in USA and has accounted for 14,970 deaths in 2018 [1]. Metastasis from RCCs is common, and in approximately 25% of patients, metastasis is already present during RCC diagnosis [2]. RCC primarily metastasizes to the lung, liver, bone, and adrenal tissue [3]. PmRCC often occurs a long time after nephrectomy, which makes them difficult to detect [7,8,9,10]. Patients with PmRCC choose the Departments of General/ Pancreatic Surgery as the First Clinical Department. It is difficult to differentiate PmRCC from pancreatic neuroendocrine tumor (PNET), pancreatic ductal adenocarcinoma, or other primary pancreatic tumors, as each of them has different therapeutic modalities with different prognoses
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