Kataoka M, Hirano Y, Kondo H, Ishikawa S, Yamaguchi S. Laparoscopic right hemicolectomy for metastatic renal cell carcinoma in the ascending colon: A case report.
Int J Surg Case Rep 2020;
74:214-217. [PMID:
32892122 PMCID:
PMC7481497 DOI:
10.1016/j.ijscr.2020.08.050]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 08/26/2020] [Accepted: 08/26/2020] [Indexed: 11/29/2022] Open
Abstract
Although it is rare, renal cell carcinoma can metastasize to the colon.
Colonic metastasis can cause abdominal symptoms, hematochezia, or anemia.
Resection of colonic metastasis, if solitary, may result in long-term prognosis.
Introduction
Renal cell carcinoma (RCC) arises from the renal parenchyma and is the most common primary malignancy of the kidney. RCC frequently metastasizes to the lung, bone, lymph nodes, and other locations, but rarely to the colon. We report a case of metastatic RCC of the ascending colon that was successfully resected with laparoscopic right hemicolectomy.
Presentation of case
The patient is a 65-year-old man who developed hip joint pain and was diagnosed with polymyalgia rheumatica during the first year after laparoscopic right nephrectomy for right RCC. A screening colonoscopy was performed and a tumor was found in the ascending colon. Biopsy strongly suggested metastatic RCC. No other distant metastases were found, and laparoscopic right hemicolectomy was performed. The tumor extended from the mucosa to the subserosa and was diagnosed histopathologically as colonic metastasis of RCC. There were no lymph node metastases in the simultaneously resected mesentery, but venous invasion was observed.
Discussion
RCC can metastasize to various organs, but metastasis to the colon is extremely rare. In cases of colon metastasis, abdominal symptoms, hematochezia, or anemia may occur, and their occurrence should be checked during follow-up. Based on past reports, resection of metastatic lesion is considered the most appropriate treatment.
Conclusion
Although it is rare for RCC to metastasize to the colon, it is possible. Resection can be recommended for colon metastasis with no other metastases, and colectomy with R0, including the regional mesocolon, may provide a favorable long-term prognosis.
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