Pancreatitis with local recurrence of renal cell carcinoma involving the main pancreatic duct

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  • 左腎細胞癌局所再発が主膵管内進展を来して膵炎を繰り返した1例

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<p>A 40-year-old man underwent left nephrectomy for renal cell carcinoma 3 years previously. Chemotherapy for residual lung metastases was given postoperatively, but was interrupted by episodes of pancreatitis. Three mass lesions were found in the tail of the pancreas by CT scan. The masses were considered a local recurrence around the pancreas, causing pancreatitis. Distal pancreatectomy was planned to allow continuation of chemotherapy. Pathological examination revealed that the lesions around the pancreatic tail were consistent with local recurrence of renal cell carcinoma. The tumor advanced like an embolus into the main pancreatic duct with chronic inflammation in the caudal pancreas. Repeat episodes of pancreatitis were due to obstruction of the main pancreatic duct by recurrent tumor. Although renal cell carcinoma is known to progress into large vessels including the inferior vena cava, no pathological features such as the capsule formation seen with intra-vascular spread were found in the intra-pancreatic ductal lesion. Chemotherapy for residual lung metastases was resumed postoperatively and continued without further episodes of pancreatitis. Resection of recurrent renal cell carcinoma, even though it is incurable, may be justified to allow continued administration of effective chemotherapy.</p>

Journal

  • Suizo

    Suizo 36 (2), 135-141, 2021-04-30

    Japan Pancreas Society

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