A case of a solid renal mass together with a cystic pancreatic lesion in a 50-year-old patient

Abstract

Context: Pancreatic cysts may be incidentally detected in asymptomatic patients evaluated for other clinical manifestations. Microcystic adenomas are particularly rare among pancreatic cyst neoplasms. They are benign lesions and can present as solitary pancreatic tumors or as a radiological manifestation combined with other cystic and tumoral lesions affecting different organs.

Case report: A 50-year-old man presented with hematuria. A computed tomography scan of the abdomen showed a 9-centimeter renal mass in the left kidney consistent with a renal-cell carcinoma as well as a cystic lesion the head of the pancreas. The histopathological study of the cystic mass, following a computed tomography guided biopsy, showed a microcystic adenoma. Therefore, further studies were performed so as to assess the relationship between both lesions and determine the final diagnosis.

Conclusions: Microcystic adenomas are exceedingly rare tumors among pancreatic cysts. The combination of a solid renal mass and a pancreatic cystic lesion should lead to a broad differential diagnosis. Pancreatic magnetic resonance imaging has been proven to be particularly useful in evaluating cystic masses. The presence of walls and internal septations in the pancreatic mass with gadolinium enhancement should raise the possibility of an underlying Von Hippel-Lindau syndrome.