Clear cell renal carcinoma metastases to the pancreas
Authors:
K. Rupert 1,2; T. Kural 1,2; T. Skalický 1,2; J. Zeithaml 1; O. Hess 3; V. Třeška 1,2
Authors‘ workplace:
Chirurgická klinika Fakultní nemocnice Plzeň
1; Lékařská fakulta v Plzni, Univerzita Karlova
2; Šiklův ústav patologie Fakultní nemocnice Plzeň
3
Published in:
Rozhl. Chir., 2020, roč. 99, č. 7, s. 311-315.
Category:
Original articles
doi:
https://doi.org/10.33699/PIS.2020.99.7.311–315
Overview
Introduction: To date, clear cell renal carcinoma (Grawitz tumour) remains the most frequent malignant tumour of the kidney in adults. It metastasises in more than 25% of cases, most frequently to the bones (osteolytic metastases), lungs, brain, liver, adrenal glands and the contralateral kidney. Metastases to the pancreas are rare and represent 1–4% of all malignant tumours of the pancreas.
Methods: This is a retrospective analysis of patients who were operated at the Department of Surgery in Pilsen between 2010 and 2018 for histologically verified metastasis of clear cell carcinoma (Grawitz tumour) to the pancreas.
Results: We operated 12 patients (8 men and 4 women). The metastases appeared on average 8 years and 8 months following the primary urological surgery. The mean age of the male patients was 66.5 years and that of the female patients was 67.4 years.
In our sample, the diagnostic specificity of the CT scan was 50%, the diagnostic specificity of endoscopic ultrasound (EUS) was 75% and subsequent EUS-guided fine needle aspiration biopsy performed in 100% of cases yielded a specificity of 75%. Resectability was 92%. The average length of hospitalisation was 11.5 days. Post-operative complications according to Clavien-Dindo were grade 1 in 66%, grade 2 in 1.25% and grade 5 in 8.3% of the cases. The 30-day post-operative mortality was 8.3% (one patient).
Conclusion: Clear cell renal carcinoma metastases to the pancreas are very rare. However, if radically removed, the patient has a good prognosis with regards to long-term survival.
Keywords:
diagnosis – clear cell renal carcinoma – surgical treatment – metastases to the pancreas
Sources
- Benhaim R, Oussoultzoglou E, Saeedi Y, et al. Pancreatic metastasis from clear cell renal cell carcinoma: outcome of an aggressive approach. Urology 2015;85:135–140. doi:10.1016/j.urology.2014.09.034.
- Dong J, Cong L, Zhang TP, et al. Pancreatic metastasis of renal cell carcinoma. Hepatobiliary Pancreat Dis Int. 2016;15:30–38. doi:10.1016/s1499-3872(16)60052-8.
- Noguchi G, Nakaigawa N, Taguri M, et al. Time-dependent change in relapse sites of renal cell carcinoma after curative surgery. Clin Exp Metastasis 2018;35(1–2):69–75. doi:10.1007/s10585-018-9883-0.
- Okasha HH, Al-Gemeie EH, Mahdy RE. Solitary pancreatic metastasis from renal cell carcinoma 6 years after nephrectomy. Endoscopic Ultrasound 2013;2(4):222–224. doi:10.4103/2303-9027.121248.
- Rupert K, Kural T, Skalický T, et al. Pancreatic metastases from renal cell carcinoma. Pancreatic Dis Ther. 2012;2:103. doi:10.4172/2165-7092.1000103.
- Sanghwa Ko, Sungpil Yun, Suk Kim, et al. Pancreatic resection for renal cell carcinoma metastasis: a case review. Ann Hepatobiliary Pancreat Surg. 2017;21(3):176–179. doi:10.14701/ahbps.2017.21.3.176.
- Gilbert CM, Monaco SE, Cooper ST, et al. Endoscopic ultrasound-guided fine-needle aspiration of metastases to the pancreas: A study of 25 cases. Cytojournal 2011;8:7. doi:10.4103/1742-6413.79779.
- Smith AL, Odronic SI, Springer BS, et al. Solid tumor metastases to the pancreas diagnosed by FNA: a single-institution experience and review of the literature. Cancer Cytopathology 2015;123(6):347–355. doi:10.1002/cncy.21541.
- Chang YH, Liaw CC, Chuang CK. The role of surgery in renal cell carcinoma with pancreatic metastasis. Biomed J. 2015;38:173–176. doi:10.4103/2319-4170.137771.
- Konstantinidis IT, Dursun A, Zheng H, et al. Metastatic tumors in the pancreas in the modern era. J Am Coll Surg. 2010;211(6):749–53. doi:10.1016/j.jamcollsurg.2010.08.017.
- Niess H, Conrad C, Kleespies A, et al. Surgery for metastasis to the pancreas: is it safe and effective? J Surg Oncol. 2013 [on line]. doi:10.1002/jso.23333.
- Calvo E, Schmidinger M, Heng DY, et al. Improvement in survival end points of patients with metastatic renal cell carcinoma through sequential targeted therapy. Cancer Treat Rev. 2016;50:109–117. doi:10.1016/j.ctrv.2016.09.002.
- Cheong D, Rho SY, Kim JH, et al. Laparoscopic pancreaticoduodenectomy for renal cell carcinoma metastasized to ampulla of Vater: A case report and literature review. Ann Hepatobiliary Pancreat Surg. 2018;22(1):83–89. doi:10.14701/ahbps.2018.22.1.83.
- Sperti C, Pozza G, Brazzale AR, et al. Metastatic tumors to the pancreas: A systematic review and meta-analysis. Minerva Chirurgica 2016;71(5):337–344.
- Grassi P, Verzoni E, Mariani L, et al. Prognostic role of pancreatic metastases from renal cell carcinoma: results from an Italian center. Clin Genitourin Cancer 2013;11:484–488. doi:10.1016/j.clgc.2013.04.022.
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Surgery Orthopaedics Trauma surgeryArticle was published in
Perspectives in Surgery
2020 Issue 7
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