The role of surgery in renal cell carcinoma metastatic to the pancreas: A single-institution experience

Abstract

s / Pancreatology 13 (2013) e1–e94 e57 old female. Routine follow-up carried out for five years demonstrated a 35 mmmass localized on the body of the pancreas. The tumor was resected by subtotal pancreasectomy. Histopathologically the specimen was also positive to S-100. The feature of the primary cutaneous lesionwas a superficial spreading tumor in accordance with the anatomical Clark level of IV (melanoma invasive to the reticular dermis). The tumor resected from the pancreas showed heavy brownish pigmentation. Melanin pigment was clearly evident in cytoplasms. An immunohistochemical examination revealed that the tumor cells were positive for HMB-45 and S-100 protein. Thepostoperative coursewasuneventful andno chemotherapywasgiven. The follow-up after three years has shown no relapse of the disease. Discussion: The surgical treatment of metastatic disease is still controversial. Furthermore distinction should be carried out properly. Allen & Spitz have established histopathological criteria for the diagnosis of metastatic, as opposed to primary melanoma. Metastatic melanoma of the pancreas is considered to be a sign of disseminated disease at the time of diagnosis and that could be considered a poor prognosis. Conclusion: In this case the long term survival after the operation would suggest the possible role of surgery in the treatment of metastasis of melanoma of the pancreas.