Pancreatic and gastric metastases occurring a decade after nephrectomy for renal cell carcinoma

: We report the case of a 64-year-old man who underwent resection on two occasions for recurrent renal cell carcinoma. He first underwent right nephrectomy for renal cell carcinoma, and 10 years later, he underwent pylorus-preserving pancreaticoduodenectomy for pancreatic metastasis. Microscopic extracapsular invasion without lymph node metastasis was observed at that time. Twelve years after the first surgery, he was diagnosed with stomach metastasis. Clinically, metastases to other organs was not observed, and endoscopic ultrasonography revealed no changes in the submucosal layer; endoscopic submucosal dissection was subsequently performed. Pathologically, the tumor was found to be localized in the mucosal layer. There has been no occurrence of metastases for 2 years and 6 months since the last surgery.