Metastasis from Renal Cell Carcinoma to Ectopic Pancreas Diagnosed after Resection

Yano, Ryo; Yokota, Tomoyuki; Morita, Makoto; Amano, Michiko; Ochi, Hironori; Azemoto, Nobuaki; Mashiba, Toshie; Joko, Koji

doi:10.2169/internalmedicine.9731-22

Cited by 2 publications

(2 citation statements)

References 18 publications

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“…In single and multicentre institutional reports of isolated PM [99,143,183,185,191,201,209,216,234], comparable results were reported with five-year SR of 52%-84%, 53% [99], 61% [143], 52% [183], 72% [184], 56% [190], 71% [200], 69% [208], 80% [215], 84% (Median 72%) [233]. 10a: 63% (median 69%) [254]. This also applies to the reports that additionally included cases with synchronously resected extrapancreatic metastases in their analyses [134,176,181,191,195,211,229,232,235,239,242,243] 88% [134]; 77% [176]; 63% [181], 79% [191], 72% [195], 50% [211], 72% [232], 79% [235], 81% [239], 68% [242], 83% [243], 77% [229].…”

Section: Surgical Therapysupporting

confidence: 58%

Isolated Pancreatic Metastases of Renal Cell Carcinoma—Clinical Particularities and Seed and Soil Hypothesis

Sellner

Thalhammer

Klimpfinger

2023

Cancers

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A meta-analysis of 1470 isolated pancreatic metastases of renal cell carcinoma revealed, that, in addition to the unusual exclusive occurrence of pancreatic metastases and the favourable treatment results, the isPMRCC is characterised by further peculiarities of the clinical course: The lack of prognostic significance of volume and growth rate dependent risk factors and the independence of treatment results from standard or local resections. As an explanation for all these peculiarities, according to today’s knowledge, a strong acting seed and soil mechanism can serve, which allows embolized tumour cells to grow to metastases only in the pancreas, and prevents them definitively or for years in all other organs. The good prognosis affects not only isolated PM, but also multi-organ metastases of the RCC, in which the additional occurrence of PM is also associated with a better prognosis. Genetic studies revealed specific changes in cases of PM of RCC: Lack of loss of 9p21.3 and 14q31.2, which are otherwise specific gene mutations at the onset of generalization, a low weight genome instability index, i.e., high genetic stability, and a low rate of PAB1 and a high rate of BPRM1 alterations, which signal a more favourable course. The cause of pancreatic organotropism in isPMRCC is still unclear, so only those factors that have been identified as promoting organotropism in other, more frequent tumour entities can be presented: Formation of the pre-metastatic niche, chemokine receptor–ligand mechanism, ability to metabolic adaptation, and immune surveillance.

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Section: Surgical Therapysupporting

confidence: 58%

Isolated Pancreatic Metastases of Renal Cell Carcinoma—Clinical Particularities and Seed and Soil Hypothesis

Sellner

Thalhammer

Klimpfinger

2023

Cancers

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“…PM are most frequently seen in ccRCC [ 31 , 32 , 33 ]. PM from RCC have also been reported in ectopic pancreatic tissue, such as in the case reported by Yano et al [ 34 ]. Moreover, as reported in one of our cases, digestive involvement of RCC metastasis includes gastrointestinal tract (stomach, duodenum, colon), ampulla of Vater and gallbladder in addition to the pancreas.…”

Section: Discussionmentioning

confidence: 88%

Metastatic Renal Cell Carcinoma to Pancreas: Case Series and Review of the Literature

et al. 2023

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Metastasis to the pancreas represents a small proportion of all pancreatic malignancies. Among primary tumors that metastasize to the pancreas, renal cell carcinoma (RCC) is one of the most common causes of metastatic pancreatic lesions. We herein report a case series of three patients with pancreatic metastasis from RCC. The first is a 54-year-old male with a history of left nephrectomy for RCC, in whom an isthmic pancreatic mass suggestive of a neuroendocrine lesion was found during oncological follow-up. Endoscopic ultrasound (EUS)-guided fine needle biopsy (FNB) identified pancreatic metastasis of RCC and the patient was referred for surgery. The second case is a 61-year-old male, hypertensive, diabetic, with left nephrectomy for RCC six years previously, who complained of weight loss and was found with a hyperenhancing mass in the head of the pancreas and a lesion with a similar pattern in the gallbladder. EUS-FNB from the pancreas proved to be a metastatic pancreatic lesion. Cholecystectomy and treatment with tyrosine kinase inhibitors were recommended. The third case is a 68-year-old dialysis patient referred for evaluation of a pancreatic mass, also confirmed by EUS-FNB, who was started on sunitinib treatment. We report a literature summary on epidemiology and clinical features, diagnosis and differential diagnosis and treatment and outcomes in pancreatic metastasis of RCC.

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Metastasis from Renal Cell Carcinoma to Ectopic Pancreas Diagnosed after Resection

Cited by 2 publications

References 18 publications

Isolated Pancreatic Metastases of Renal Cell Carcinoma—Clinical Particularities and Seed and Soil Hypothesis

Isolated Pancreatic Metastases of Renal Cell Carcinoma—Clinical Particularities and Seed and Soil Hypothesis

Metastatic Renal Cell Carcinoma to Pancreas: Case Series and Review of the Literature

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