Curative‐Intent Pancreatectomy for Pancreatic Metastasis From Renal Cell Carcinoma 30 Years After Nephrectomy Following Lenvatinib Plus Pembrolizumab Therapy: A Case Report
Yuta Kaneko, Reo Kotorii, Kaishi Shimizu, Kazuma Miura, Yosuke Nakanishi, Ken Nakamura, Seiya Hattori, Yasuto Yagi, Toru Nishiyama, Tetsuo MommaABSTRACT
Introduction
Renal cell carcinoma (RCC) is the most common primary site of pancreatic metastases, and complete resection confers a favorable prognosis. Lenvatinib plus pembrolizumab (LEN + PEM) is standard first‐line therapy for advanced RCC; however, induction therapy before resection of pancreatic metastasis has not been reported.
Case Presentation
A 77‐year‐old man presented with weight loss, anemia, and elevated inflammatory markers 30 years after radical nephrectomy for RCC. Contrast‐enhanced computed tomography revealed a 42‐mm pancreatic head mass compressing the inferior vena cava, considered resectable, but high risk. Endoscopic ultrasound‐guided fine‐needle aspiration confirmed metastatic clear cell RCC. After LEN + PEM induction, the tumor decreased to 29 mm, vena cava compression resolved, and subtotal stomach‐preserving pancreaticoduodenectomy achieved R0 resection. The patient remained recurrence‐free at 5 months.
Conclusion
LEN + PEM induction enabled R0 resection of pancreatic RCC metastasis, a site for which this strategy has not previously been reported.