Pancreatic metastases account for only a small proportion of all pancreatic malignancies. Isolated pancreatic metastasis from renal cell cancer (isPM-RCC) is extremely rare and may be difficult to differentiate from more common primary neoplasms. A history of nephrectomy is crucial for the diagnosis.

We report the case of a 64-year-old Asian man who was diagnosed with a mass in the pancreatic head using computed tomography. He had no related symptoms, and his medical history was unremarkable, except for unilateral nephrectomy performed to remove a “benign” tumor 19 years ago. All preoperative imaging findings suggested a diagnosis of pancreatic neuroendocrine tumor. However, ultrasound-guided biopsy revealed features of clear cell renal cell carcinoma (ccRCC). Re-examination of the specimen resected 19 years ago confirmed that he had a ccRCC. The pancreatic mass was resected and pathological examination confirmed isPM-RCC.

Misdiagnosis of isPM-RCC is common because of its rarity and the long interval from resection of the primary tumor and manifestation of the metastasis. The history of the previous surgery may be the only clue.

• Renal cell carcinoma
• Pancreatic neuroendocrine tumor
• Pancreatic metastases
• Case report

Renal cell carcinoma (RCC) is the most common renal tumor, accounting for 2%-3% of all malignancies. Though RCC is known to spread hematogenously, isolated RCC metastasis to the stomach is a rare event. In this article, we describe the clinical course of a patient who developed a pancreatic recurrence of RCC and 1 year later a gastric recurrence of RCC treated 10 years ago with a resection and interleukin-2 (IL-2).

Accumulating evidence indicates that metastatic involvement of the pancreas and stomach should be suspected in any patient with a history of RCC who presents with gastrointestinal symptoms even 10 years after RCC resection and immunotherapy.

• Renal cell carcinoma
• Stomach metastasis
• Interleukin-2 treatment

• Aged
• Carcinoma, Renal Cell/pathology
• Carcinoma, Renal Cell/therapy
• Humans
• Immunotherapy
• Interleukin-2/therapeutic use
• Kidney Neoplasms/pathology
• Kidney Neoplasms/therapy
• Male
• Neoplasm Metastasis
• Pancreatic Neoplasms/diagnosis
• Pancreatic Neoplasms/secondary
• Recurrence
• Stomach Neoplasms/diagnosis
• Stomach Neoplasms/secondary