Interest of intraoperative ultrasonography during pancreatectomy for metastatic renal cell carcinoma

Clin Res Hepatol Gastroenterol. 2013 Nov;37(5):530-4. doi: 10.1016/j.clinre.2013.01.006. Epub 2013 Mar 13.

Abstract

Background: Isolated pancreatic metastases from renal cell carcinoma may be treated by surgical resection in a curative intent. As they are frequently multiple, a good imaging workup is mandatory to plan the appropriate resection. The aim of this study was to define the imaging workup that should be performed in this setting.

Methods: We reviewed all patients who underwent pancreatic resection for metastasis of renal cell carcinoma in a single centre during a 20-year period. The results of the intraoperative ultrasonography were compared to those of the preoperative imaging and the final pathology results.

Results: Thirteen patients were studied. A CT scan was always performed whereas only three patients had a MRI (only one revealed another tumor). Intraoperative ultrasonography found new tumors in 50% of patients when it was performed (4/8) and modified the management in 40% of them, while preoperative PET scan was useless.

Conclusions: Intraoperative ultrasonography is a low-cost and non-invasive technique that should be routinely included in the surgical exploration of pancreatic metastases from renal carcinoma.

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Renal Cell / mortality
  • Carcinoma, Renal Cell / pathology*
  • Diagnostic Imaging
  • Female
  • Humans
  • Intraoperative Care*
  • Kidney Neoplasms / mortality
  • Kidney Neoplasms / pathology*
  • Male
  • Middle Aged
  • Pancreas / diagnostic imaging*
  • Pancreas / pathology
  • Pancreas / surgery
  • Pancreatectomy*
  • Pancreatic Neoplasms / mortality
  • Pancreatic Neoplasms / secondary
  • Pancreatic Neoplasms / surgery*
  • Preoperative Care
  • Ultrasonography