Abstract
Pancreatic metastasis of renal cell carcinoma (RCC) is rare and can present many years after nephrectomy. It can exhibit radiological characteristics very similar to those of a pancreatic neuroendocrine tumor (pNET). Here, we present a case of an 81-year-old female who presented with an incidentally discovered solitary hypervascular pancreatic head mass with intense gallium-68-DOTA-OCTREOTATE positron emission tomography/computed tomography (Ga-68 DT-PET/CT) uptake 15 years after her initial nephrectomy for an RCC. The mass continued to grow despite somatostatin analog (SSA) therapy, prompting endoscopic ultrasound (EUS)-guided biopsy, which revealed metastatic RCC.