Complete metastasectomy to treat simultaneous metastases of the duodenum and pancreas caused by renal cell carcinoma

Yen-Cheng Chen^a, Ying-Chin Yang^a, Ming-Hsun Li^b, Hann-Chorng Kuo^c, Ming-Che Lee^a

^a Department of Surgery, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
^b Department of Pathology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
^c Department of Urology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan

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Abstract
Renal cell carcinoma (RCC) metastatic to the pancreas is relatively uncommon, and RCC metastatic to the duodenum is extremely rare, with only a small number of case reports in the literature. We describe a 76-year-old woman with a history of RCC who had been treated by radical left nephrectomy 6 years earlier. The patient presented with anemia, hematochezia, and a bulging mass in the pancreaticoduodenal area, and was treated by pancreaticoduodenectomy. Histopathology confirmed metastatic RCC of the duodenum, the pancreas, and one of the dissected regional lymph nodes. The patient remains healthy to date without recurrence more than 24 months after pancreaticoduodenectomy. Our case report and review of the literature supports the curative surgical treatment in this rare group of patients.

Keywords
Duodenum; Metastasectomy; Pancreas; Pancreaticoduodenectomy; Renal cell carcinoma