A 69-year-old asymptomatic woman with prior nephrectomy came for routine follow-up to a nephrology clinic. The patient had undergone a radical nephrectomy in 1992 for stage I right renal cell carcinoma (RCC). On her examination, she was found to have a small non-tender palpable lump in the epigastric region. Computed Tomography (CT) of the abdomen was performed.
What are the abnormalities in this Contrast enhanced axial CT and what is your diagnosis?

ANSWER

Renal cell carcinoma with pancreatic metastases

The right kidney is removed. Multiple avidly enhancing nodular lesions in the pancreas can be noted.

About one third of patients with RCC have metastases at presentation and another third develop widespread metastatic disease following nephrectomy. Late metastases after months to years following resection of the primary tumour have been documented. Lungs, bones, and contralateral kidney are common sites for distant metastases from RCC.
Metastases to pancreas are relatively rare and account for 2% of malignant masses of the pancreas.The primary malignancies metastasising to the pancreas originate most commonly from lung, colon, breast and kidney.

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3 comments

  1. Anonymous Says:
  2. Mets?? in hepatobiliary or pancreas more likely

     
  3. Azhar Says:
  4. secondaries in the liver

     
  5. Anonymous Says:
  6. Epigastric hernia

     

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