Authors:Ha-Yeon Kim, Gi-Hoon Lee, Chung-Hwan Jun, Kang-Jin Park, Sung-Bum Cho, Jin-Woong Kim, and Young-Eun Joo
Metastasis to the ampulla of Vater from renal cell carcinoma (RCC) is rarely encountered. We present the case of a 50-year-old male admitted with complaints of right upper quadrant pain and jaundice. The medical history consisted of a right radical nephrectomy, right adrenalectomy, and brain mass excision for RCC and metastasis. An esophagogastroduodenoscopy revealed a round ampullary mass with ulceration. An abdominal computed tomography scan revealed an enhancing mass in the ampulla of Vater, total pancreas, and left adrenal gland. Pathologic examination of a biopsy specimen was compatible with metastatic RCC of the clear cell type. A percutaneous transhepatic cholangiogram revealed complete obstruction of the distal common bile duct. A metal stent was inserted for bile drainage via the percutaneous transhepatic route. Patients with a history of RCC should undergo a careful long-term follow-up to detect and evaluate metastasis to usual and unusual sites.