Journal
JOURNAL OF SURGICAL CASE REPORTS
Volume -, Issue 8, Pages -Publisher
OXFORD UNIV PRESS
DOI: 10.1093/jscr/rjab368
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The article describes the treatment process of a patient with metastatic renal cell carcinoma to the pancreas causing severe gastrointestinal hemorrhage. The bleeding was successfully controlled through emergency angiogram and transarterial embolization, followed by surgical resection. The patient had few complications postoperatively, and long-term follow-up showed no recurrence.
In some patients with metastatic renal cell carcinoma to the pancreas, gastrointestinal hemorrhages occur, but because of the rarity of this condition, treatment strategies have not been established. A 71-year-old man who had undergone a nephrectomy for renal cell carcinoma (RCC) went to a hospital in a state of shock. Computed tomography revealed a hypervascularized tumor in the head of the pancreas, suggesting metastatic RCC. Upper endoscopy revealed bleeding in the duodenum due to tumor invasion. An emergency angiogram showed that the tumor received its blood supply mainly from the gastroduodenal artery. Transarterial embolization (TAE) of the gastroduodenal artery was performed and bleeding was controlled. Two months after TAE, elective pancreaticoduodenectomy was performed. The patient currently continues to undergo outpatient follow-up 2 years later without recurrence. TAE was very effective in controlling the acute phase of severe gastrointestinal hemorrhage from pancreatic metastasis of RCC.
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