CASE N°04 – Pancreatic Metastases from Renal Cell Carcinoma

Clinical History:

Age: 56

Sex:  male

The patient had a history of Renal Cell Carcinoma (RCC), clear cell variant, treated with a radical nephrectomy & no adjuvant therapy 2 years previously. One years ago he was found to have multiple pancreatic nodules (between 0,6 & 11 mm. in diameter) located in the tail. Initially the patient was suspect to have multiendocrine neoplasia due to  laboratory data & sympthoms. Now the diameter of the lesions range from 14 to 26 mm in diameter, are located either in the body both in the tail, and actually he was suspected of having RCC metastases.

Cytological Images:

Cytological speciemen: Pancreatic EUS-FNA

PAP 200X

PAP 400X

PAP 400X

Cytological Report:

Several aggregates of neoplastic cells with bland nuclear atypia & clear cytoplasm, compatible with a metastatic RCC.

Histological Images:

Histological material: Pancreatic Core Biopsy

H/E 40x

H/E 200x

Histological Report:

Small tissue fragments composed by neoplastic cells arranged in trabecular and alveolar structures with clear cytoplasm, compatible with a metastatic RCC.

Discussion:

While metastasis to the pancreas is uncommon, it may occur from renal cell carcinomas (RCCs)

When a patient with a history of RCC presents clinically with symptoms and/or laboratory data suggestive of exocrine and/or endocrine functional disturbance, as in our case, pancreatic metastasis from RCC should be considered.

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