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Case Reports
. 2025 Mar 8;20(5):2544-2548.
doi: 10.1016/j.radcr.2025.02.024. eCollection 2025 May.

A case of multiple pancreatic metastases from renal cell carcinoma mimicking a neuroendocrine tumor

Akina Miyamoto  1 , Hiroyuki Kuroda  1 , Rika Yoshida  1 , Takeshi Yoshizako  1 , Yuko Makihara  2 , Hoshio Uwabe  3 , Takashi Kishi  4 , Yasushi Kaji  1
Affiliations
Case Reports

A case of multiple pancreatic metastases from renal cell carcinoma mimicking a neuroendocrine tumor

Akina Miyamoto et al. Radiol Case Rep. .

Abstract

Herein, we present the case of a 73-year-old man with recurrent pancreatic tumors 20 years postnephrectomy for clear cell renal cell carcinoma (RCC). Imaging studies revealed multiple hypervascular tumors in the pancreas, posing a diagnostic challenge in differentiating RCC metastases from well-differentiated neuroendocrine tumors (NETs). Magnetic resonance imaging (MRI) chemical shift imaging played a pivotal role in suggesting the presence of fat, supporting RCC metastasis. Surgical resection confirmed the diagnosis.

Keywords: Neuroendocrine tumor; Pancreatic metastasis; Renal cell carcinoma; Somatostatin receptor scintigraphy.

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Figures

Fig 1
Fig. 1
Computed tomography (CT). (A) Non–contrast-enhanced CT, (B) Contrast-enhanced CT, early arterial phase, (C) Contrast-enhanced CT, late arterial phase, (D) Contrast-enhanced CT, delayed phase. The CT scans reveal multiple well-defined circular hypervascular tumors, each measuring less than 30 mm in diameter, distributed throughout the pancreas (arrows).
Fig 2
Fig. 2
Magnetic resonance imaging (MRI). (A) T2-weighted image (T2WI), (B) Diffusion-weighted image (DWI), (C) In-phase of T1-weighted image (T1WI), (D) Opposed-phase of T1WI. Pancreatic tumors show mild high signal intensity on T2WI and high signal intensity on DWI. They exhibit reduced signal intensity from in-phase to opposed-phase T1WI, indicating the presence of fat (arrows).
Fig 3
Fig. 3
Fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT). (A) 3D-MIP image, (B) FDG-PET/CT image. FDG-PET/CT shows low FDG uptake in pancreatic tumors with a maximum standardized uptake value (SUVmax) of 2.6 (arrows).
Fig 4
Fig. 4
Somatostatin receptor scintigraphy (SRS). Fusion image after the 24-hour phase. SRS reveals the accumulation of Indium-111-labeled pentetreotide in multiple pancreatic tumors (arrows).
See this image and copyright information in PMC

References

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