A Masquerading Return: When Metastatic Renal Cell Carcinoma Recurs After 20 Years to Mimic a Pancreatic Neuroendocrine Tumor on Somatostatin Receptor PET Imaging.
Abhishek Sharma, Purnima Thakur, Vipan Kumar et al.
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Case in brief
A 71-year-old man with a history of clear cell renal cell carcinoma presented with weight loss and abdominal bloating. Imaging revealed an enhancing lesion in the pancreatic head and neck, which showed intense tracer uptake on 68 Ga-DOTATATE PET, suggesting a pancreatic neuroendocrine tumor. However, histopathological examination confirmed it was a metastatic renal cell carcinoma, indicating a late recurrence.
What made this case unusual
The case is notable for the late recurrence of renal cell carcinoma, which mimicked a pancreatic neuroendocrine tumor due to somatostatin receptor expression.
Diagnostic / clinical pearl
Clinicians should consider the possibility of late recurrences of renal cell carcinoma that may present with atypical imaging characteristics, such as those resembling neuroendocrine tumors.
Why it matters
This case underscores the importance of thorough histopathological evaluation in atypical presentations of tumors, particularly in patients with a history of renal cell carcinoma.