膵転移を伴った腎細胞癌の1手術例

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We report a case of renal cell carcinoma with metastasis to the pancreas, treated by radical nephrectomy and total pancreatectomy. A 56-year-old man visited our hospital because of macrohematuria and right low backache. An intravenous pyelography, ultrasonography and a CT scan of the abdomen revealed right renal tumor at the upper portion, about 11 cm in diameter, but no abnormal findings of the pancreas. Aortic and celiac angiograms demonstrated multifocal lesions, 1 or 2 cm in size, compatible with a metastatic tumor in the region of the pancreas. The patient underwent right radical nephrectomy and open biopsy of the pancreas. The right renal tumor was histologically revealed to be renal cell carcinoma without nodal or venous extension. Histological examination of the pancreas biopsy specimen confirmed it to be a renal cell carcinoma metastatic to the pancreas. Therefore, he underwent total pancreatectomy 1 month after the previous surgery. Three months after the second surgery, a CT scan of the brain revealed metastasis to the pituitary gland. He is still under therapy.