Multiple late asymptomatic pancreatic metastases from renal cell carcinoma: diagnosis by endoscopic ultrasound-guided fine needle aspiration biopsy with immunocytochemical correlation.

We describe a patient who presented with multiple asymptomatic masses detected in the pancreas. Twelve years prior to this presentation, he underwent a left radical nephrectomy for stage I renal cell carcinoma. CT-guided biopsy was unsuccessful. Endoscopic ultrasound guided fine needle aspiration (EUS-FNA) biopsy was performed. Adequate material was obtained for various immunocytochemical stains that supported the diagnosis of renal cell carcinoma metastatic to the pancreas. The patient was referred for appropriate therapy. This case illustrates that metastasis to the pancreas from renal cell carcinoma can present years after the original diagnosis. We conclude that EUS-FNA can provide tissue diagnosis from pancreatic masses, especially when other modalities have failed.