Die singuläre Spätmetastase eines Nierenzellkarzinoms im Pankreas

A singular late metastasis of renal cell cancer inside the pancreas. An uncommon pancreatic tumor

Summary

We present the rare case of a solitary pancreatic metastasis of renal cell cancer being the only manifestation of tumordissemination. In 1993 the patient underwent a transperitoneal nephrectomy for removal of a clear cell renal cancer. In 1998 during follow up we detected a pancreatic tumor which was treated by pancreas resection, splenectomy and resection of the colon transversum. The histology revealed a metastasis of the previously resected renal cancer. The postoperative recovery was impaired by the development of an abscess in the former pancreatic region. During the first year of follow up we did not find any signs for local or distant tumor recurrence. Pancreas resection adapted to the location of the tumor is the treatment of choice for isolated solitary late metastases of renal cell cancer.

Zusammenfassung

Wir schildern den seltenen Fall einer solitären Pankreasmetastase eines Nierenzellkarzinoms als einzige Manifestation einer Tumordissemination. 1993 wurde bei dem Patienten eine transperitoneale Tumornephrektomie wegen eines hellzelligen Nierenzellkarzinoms rechts vorgenommen. Im Rahmen des Follow-up des Primärtumors fiel 1998 ein Tumor im Pankreas auf. Unter dem Verdacht eines Pankreaskarzinoms erfolgte 1999 die Pankreaslinksresektion mit Splenektomie und Colon transversum Resektion. Die histologische Aufarbeitung des Operationspräparates ergab die Metastase des vormals operierten Nierenzellkarzinoms. Im postoperativen Verlauf kam es zur Ausbildung einer Abszedierung im Pankreaslogenbereich. Das Follow-up ein Jahr postoperativ zeigte keine Hinweise auf ein Rezidiv oder eine Generalisierung des Tumorleidens. Die Pankreasresektion adaptiert an die Lokalisation des Tumors stellt die Therapie der Wahl bei diesen isolierten solitären Spätmetastasen des Nierenzellkarzinoms dar.

Key words

Renal cell cancer - metastasis - pancreas

Schlüsselwörter

Nierenzellkarzinom - Metastasen - Pankreas

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