Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 6, 2022; 10(25): 9012-9019
Published online Sep 6, 2022. doi: 10.12998/wjcc.v10.i25.9012
Misdiagnosis of pancreatic metastasis from renal cell carcinoma: A case report
Xuan-Kun Liang, Lu-Jing Li, Ye-Mei He, Zuo-Feng Xu
Xuan-Kun Liang, Lu-Jing Li, Ye-Mei He, Zuo-Feng Xu, Department of Medical Ultrasonics, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen 518107, Guangdong Province, China
Author contributions: Liang XK investigated all the clinical data of the patient, reviewed the literature and contributed to manuscript drafting; Li LJ performed the microbiological analyses and interpretation and contributed to manuscript drafting; He YM analyzed and interpreted the imaging findings; Xu ZF was responsible for EUS and biopsy, and was responsible for the revision of the manuscript for important intellectual content; all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zuo-Feng Xu, PhD, Chief Physician, Department of Medical Ultrasonics, The Seventh Affiliated Hospital of Sun Yat-sen University, No. 628 Zhenyuan Road, Guangming District, Shenzhen 518107, Guangdong Province, China. xuzuofeng77@aliyun.com
Received: March 16, 2022
Peer-review started: March 16, 2022
First decision: May 30, 2022
Revised: June 13, 2022
Accepted: July 21, 2022
Article in press: July 21, 2022
Published online: September 6, 2022
Processing time: 162 Days and 17.5 Hours
Abstract
BACKGROUND

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.

CASE SUMMARY

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.

CONCLUSION

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.

Keywords: Renal cell carcinoma; Pancreatic neuroendocrine tumor; Pancreatic metastases; Case report

Core Tip: Pancreatic metastases derived from clear cell renal cell carcinoma are rare and can be maintained for a long time and progress until years later. It is easily confused with hypervascular tumors, such as pancreatic neuroendocrine tumors (pNET). We present a case of a pancreatic mass that had undergone nephrectomy 19 years ago. Due to the lack of medical records, the clinical and imaging findings were misdiagnosed as pNET due to a false medical history. Preoperative biopsy was performed prudently, resulting in a renal-derived tumor, consistent with the findings of the pathological section obtained from the previous surgery hospital. This case highlights the importance of accurate clinical data, especially with a history of surgery, even a long time ago.