PMC6597482_01
Axial view CT scan of the abdomen showing a metastatic lesion in the head of the pancreas.
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The patient was in remission for 6 years post-nephrectomy when she presented with a solitary lesion in the head of the pancreas that was discovered upon surveillance (Fig. 1).
Histopathology of the head of pancreas showing RCC metastasis (A), in contrast to normal pancreatic tissue (B).
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It was then resected via a Whipple procedure, interestingly, histopathology reported it as a multi-focal lesion of renal cell carcinoma rather than a solitary lesion (Fig. 2).
Thyroid ultrasound showing a nodule in the left lobe of the thyroid gland.
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Subsequently, a fine needle aspiration was done, which revealed RCC metastasis, so the patient underwent a total thyroidectomy (Figs. 3 & 4 ).
Histopathology showing subcutaneous tissue (A) with a lesion consistent with RCC metastasis (B).
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Six months later, the patient presented with a mass on the anteromedial aspect of the forearm, which was biopsied and confirmed to be yet another metastatic lesion of RCC, and thus it was excised with negative margins (Fig. 5).
CT scan showing multiple metastatic lesions in the pancreas post Whipple procedure.
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Following the discovery of the subcutaneous lesion on the forearm, metastatic workup was promptly performed, and CT scan showed multiple enhanced pancreatic lesions (Fig. 6).