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• W2912090284 abstract "Metastatic lesions to the pancreas are exceedingly rare, with reported occurrence of less than 2% of all pancreatic masses. Unlike other malignancies that present with systemic disease when metastases are present, certain cancers such as melanoma, renal cell carcinoma, and breast cancer can have a predilection for the pancreas. It is not uncommon for metastasis to occur decades after the primary site is treated, complicating the diagnosis. The following case represents a routine indication for endoscopic ultrasound that results in a rare and surprising diagnosis. A 70-year-old male with a past oncologic history of renal cell carcinoma and squamous cell lung cancer was referred for endoscopic ultrasound for an incidentally found pancreatic mass on surveillance imaging. The patient reported a history of a right nephrectomy for renal cell carcinoma in 1982. He did well until 2015 when he was diagnosed with stage IIB T3 N0M0 squamous cell carcinoma of the lung treated with chemoradiation. He had no evidence of disease on most recent CT, however an incidental 4.1cm x 3.1cm hyperattenuating mass was identified in the body of the pancreas concerning for a new primary malignancy. He was referred for endoscopic ultrasound to obtain tissue which revealed a round, well-defined, isoechoic mass measuring 2.9cm x 3.1cm in the pancreatic body with obvious extension into the splenic vein. Fine needle aspiration via transgastric approach revealed tumor cells consistent with metastatic renal cell carcinoma. Isolated metastatic disease of the pancreas is typically asymptomatic and often found incidentally on imaging studies. Multiple case series have shown a lag time in development of metastatic disease after primary renal cell carcinoma has occurred. One prominent study reports that the average time to development of metastatic disease is typically 15 years after initial presentation. Currently it is reported that metastatic renal cell carcinoma isolated to the pancreas can be managed either surgically or medically with similar outcomes. Our patient was not a surgical candidate given multiple comorbidities. Endoscopists should be suspicious of pancreatic metastasis in patients with a history of renal cell carcinoma who present with isolated pancreatic lesions regardless of the time span from primary diagnosis." @default.
• W2912090284 created "2019-02-21" @default.
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• W2912090284 date "2017-10-01" @default.
• W2912090284 modified "2023-10-18" @default.
• W2912090284 title "An Unexpected Case of Metastatic Disease" @default.
• W2912090284 doi "https://doi.org/10.14309/00000434-201710001-02043" @default.
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