Clear cell renal cell carcinoma with late metastasis to the pancreas and liver

Abstract

Background. Metastases from clear cell renal cell carcinoma to the pancreas and to the liver are rare. Their presentation can be asymptomatic, and so detection after nephrectomy is often delayed.                                                                                                                            

Clinical case. A 76-year-old woman had a surgical history, 26 years earlier, of right nephrectomy due to renal cell carcinoma.  Years later, she presented with tumors in the pancreas and liver, for which she underwent distal pancreatectomy and treatment with pazopanib, respectively. The pancreatic nodule was positive for cytokeratin 8, 18, and cd10, and liver biopsy reported malignant epithelial neoplasia. Both results were consistent with metastatic clear cell renal cell carcinoma.                                                                          

Discussion. The patient is currently asymptomatic and in follow-up and surveillance. Due to the biologic nature of renal cell carcinoma, its metastases must be contemplated, for early stage detection and opportune treatment.