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Renal neuroendocrine tumour and synchronous pancreas metastasis: histopathological diagnosis using prostatic acid phosphatase
  1. Keishi Kawasaki1,2,
  2. Yoshikuni Kawaguchi1,3,
  3. Yoshio Suzuki4,
  4. Nobutaka Tanaka1
  1. 1Department of Surgery, Asahi General Hospital, Chiba, Japan
  2. 2Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
  3. 3Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
  4. 4Department of Pathology, Asahi General Hospital, Chiba, Japan
  1. Correspondence to Dr Yoshikuni Kawaguchi; yokawaguchi-tky{at}


A woman aged 56 years developed 2 synchronous tumours: one, 1.2 cm in diameter at the head of the pancreas; and the other, 4.0 cm in diameter, at the left side of her horseshoe kidney. Preoperative differential diagnosis of these hypovascular lesions included pancreatic ductal carcinoma (PDC) with renal metastasis, PDC with renal angiomyolipoma, renal cell carcinoma with pancreatic metastasis or PDC and renal cell carcinoma. Following pancreaticoduodenectomy and left nephrectomy, both specimens were diagnosed as grade 2 neuroendocrine tumours (NETs). Immunohistochemistry revealed that both were positive for prostatic acid phosphatase (PAP), which is specific to hindgut-derived NET, including renal NET. Accordingly, the renal tumour was diagnosed as the primary lesion, and the pancreatic tumour as a metastasis. To the best of our knowledge, this is the first report of a renal NET with a synchronous pancreas metastasis. Immunohistochemical staining for PAP was a useful diagnostic marker for synchronous NETs in the kidney and pancreas.

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  • Contributors YK and KK contributed to the study concept; KK and YK contributed to drafting the article; KK and YS contributed to acquisition of data; KK and NT contributed to critical revision and NT contributed to study supervision.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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