Metastatic Renal Cell Carcinoma to Duodenum and Pancreas 10 Years After Nephrectomy: A Case Report

Mahsa Akbari Oryani; Azade Zare; Mohsen Soltani Sabi; Mohammad Taghi  Mashhadi-Rajabi

doi:10.18502/crcp.v7i4.11598

Mahsa Akbari Oryani Department of Pathology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Azade Zare Department of Pathology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Mohsen Soltani Sabi Department of Neurology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Mohammad Taghi Mashhadi-Rajabi Department of Surgery, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

DOI: https://doi.org/10.18502/crcp.v7i4.11598

Keywords: Renal cell carcinoma; Metastases; Duodenum; Surgery; Case report

Abstract

Renal cell carcinoma (RCC) accounts for 2-3% of the malignant tumors in adult patients. The most common sites of metastasis are the lung, bone, liver and brain respectively. Unusual metastatic sites require attention during follow-up of renal cell carcinoma. The duodenum and pancreas are uncommon sites for metastasis from renal cell carcinoma. We describe here a 62-year-old man with metastastic renal cell carcinoma to the duodenum and pancreas. The patient presented with melena and bowel obstruction, 10 years after nephrectomy for renal cell carcinoma, then with initial diagnosis of ampula vater adenocarcinoma undergo an exploratory laparotomy and a mass was found in duodenum, vater ampulla and pancreas, then pancreaticoduodenectomy was performed. histopathological examination of mass showed a metastatic renal cell carcinoma with sarcomatoid component. In conclusion, patients after radical nephrectomy due to renal cell carcinoma require long-term systematic monitoring. Gastrointestinal metastasis from Renal cell carcinoma should be considered in nephrectomized patients with gastrointestinal symptoms.