Search

A patient for whom the diagnosis of a pancreatic metastasis from renal cell carcinoma was made with endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is presented. The patient was a 77-year-old man. Three years after resection of renal cell carcinoma (T3bN0M1 Stage 4), a lung metastasis was found on computed tomography (CT) scan, and chemotherapy scheduled. Tests were positive for HBc antibodies on preoperative screening, and abdominal ultrasound showed a well-defined, hypoechoic mass in the head of the pancreas. EUS-FNA was performed for definitive diagnosis. The pathological results were consistent with metastasis to the pancreas from the previous renal cell carcinoma. In diagnosing a pancreatic metastasis from renal cell carcinoma, contrast-enhanced CT scan and angiography are useful to differentiate the lesion from pancreatic cancer, but contrast studies cannot always be performed because of renal dysfunction, contrast agent allergies, or other reasons. Even when contrast studies are performed, it is difficult to differentiate pancreatic metastases from renal cell carcinoma and pancreatic neuroendocrine tumors, and histological diagnosis is generally considered necessary.