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Omery BM, Rojas RF. FDG-Avid Metastatic Non-Clear Cell Renal Cell Carcinoma Presenting as Intussusception. Clin Nucl Med 2024:00003072-990000000-01194. [PMID: 38934462 DOI: 10.1097/rlu.0000000000005359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
ABSTRACT A 47-year-old man with a history of metastatic non-clear cell left renal cell carcinoma, unclassified subtype, status post left radical nephrectomy 4 years prior, and treated with immunotherapy for approximately 2½ years, presented for 18F-FDG PET/CT exam 7 months after immunotherapy was stopped. A contrast-enhanced CT exam performed 3 weeks prior demonstrated a new small bowel intussusception in the left upper quadrant. The PET/CT demonstrated focal FDG uptake in the segment of small bowel involved in the intussusception. Pathology from small bowel resection demonstrated metastatic renal cell carcinoma.
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Affiliation(s)
- Bilal M Omery
- From the Department of Radiology, Aurora St Luke's Medical Center, Milwaukee, WI
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2
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Todorovic Đ, Stojanovic B, Filip M, Đorđevic Đ, Stankovic M, Jovanovic I, Spasic M, Milosevic B, Cvetkovic A, Radovanovic D, Jovanovic M, Stojanovic BS, Pantic D, Cvetkovic D, Jovanovic D, Markovic V, Stojanovic MD. Small Bowel Perforation Due to Renal Carcinoma Metastasis: A Comprehensive Case Study and Literature Review. Diagnostics (Basel) 2024; 14:761. [PMID: 38611674 PMCID: PMC11011689 DOI: 10.3390/diagnostics14070761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 03/28/2024] [Accepted: 04/01/2024] [Indexed: 04/14/2024] Open
Abstract
This case report presents a unique instance of small bowel perforation caused by solitary metastasis from renal cell carcinoma (RCC), a rare and complex clinical scenario. The patient, a 59-year-old male with a history of RCC treated with nephrectomy four years prior, presented with acute abdomen symptoms. Emergency diagnostic procedures identified a significant lesion in the small intestine. Surgical intervention revealed a perforated jejunal segment due to metastatic RCC. Postoperatively, the patient developed complications, including pneumonia and multi-organ failure, leading to death 10 days after surgery. Histopathological analysis confirmed the metastatic nature of the lesion. This case underscores the unpredictable nature of RCC metastasis and highlights the need for vigilance in post-nephrectomy patients. The rarity of small bowel involvement by RCC metastasis, particularly presenting as perforation, makes this case a significant contribution to medical literature, emphasizing the challenges in the diagnosis and management of such atypical presentations.
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Affiliation(s)
- Đorđe Todorovic
- Department of Urology, University Clinical Center Kragujevac, 34000 Kragujevac, Serbia; (Đ.T.); (M.F.); (Đ.Đ.); (D.P.)
| | - Bojan Stojanovic
- Department of Surgery, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; (M.S.); (B.M.); (A.C.); (D.R.)
| | - Milutinovic Filip
- Department of Urology, University Clinical Center Kragujevac, 34000 Kragujevac, Serbia; (Đ.T.); (M.F.); (Đ.Đ.); (D.P.)
| | - Đorđe Đorđevic
- Department of Urology, University Clinical Center Kragujevac, 34000 Kragujevac, Serbia; (Đ.T.); (M.F.); (Đ.Đ.); (D.P.)
| | - Milos Stankovic
- Department of Surgery, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; (M.S.); (B.M.); (A.C.); (D.R.)
| | - Ivan Jovanovic
- Center for Molecular Medicine and Stem Cell Research, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia;
| | - Marko Spasic
- Department of Surgery, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; (M.S.); (B.M.); (A.C.); (D.R.)
| | - Bojan Milosevic
- Department of Surgery, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; (M.S.); (B.M.); (A.C.); (D.R.)
| | - Aleksandar Cvetkovic
- Department of Surgery, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; (M.S.); (B.M.); (A.C.); (D.R.)
| | - Dragce Radovanovic
- Department of Surgery, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; (M.S.); (B.M.); (A.C.); (D.R.)
| | - Marina Jovanovic
- Department of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia;
| | - Bojana S. Stojanovic
- Department of Pathophysiology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia;
| | - Damnjan Pantic
- Department of Urology, University Clinical Center Kragujevac, 34000 Kragujevac, Serbia; (Đ.T.); (M.F.); (Đ.Đ.); (D.P.)
- Department of Surgery, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; (M.S.); (B.M.); (A.C.); (D.R.)
| | - Danijela Cvetkovic
- Department of Genetics, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia;
| | - Dalibor Jovanovic
- Department of Pathology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; (D.J.); (M.D.S.)
| | - Vladan Markovic
- Department of Radiology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia;
| | - Milica Dimitrijevic Stojanovic
- Department of Pathology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; (D.J.); (M.D.S.)
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Coelho MD, Sequeira C, Freire R, Oliveira AP. Small bowel intussusception from an underlying MALT Lymphoma: A double rarity case report. Hematol Transfus Cell Ther 2024; 46:96-98. [PMID: 36522275 PMCID: PMC10935456 DOI: 10.1016/j.htct.2022.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 07/21/2022] [Accepted: 08/31/2022] [Indexed: 11/20/2022] Open
Affiliation(s)
- Mariana Dias Coelho
- Gastroenterology Department, Hospital de São Bernardo, Centro Hospitalar de Setúbal, Rua Camilo Castelo Branco 175, Setúbal 2910-549, Portugal.
| | - Cristiana Sequeira
- Gastroenterology Department, Hospital de São Bernardo, Centro Hospitalar de Setúbal, Rua Camilo Castelo Branco 175, Setúbal 2910-549, Portugal
| | - Ricardo Freire
- Gastroenterology Department, Hospital de São Bernardo, Centro Hospitalar de Setúbal, Rua Camilo Castelo Branco 175, Setúbal 2910-549, Portugal
| | - Ana Paula Oliveira
- Gastroenterology Department, Hospital de São Bernardo, Centro Hospitalar de Setúbal, Rua Camilo Castelo Branco 175, Setúbal 2910-549, Portugal
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Wasifuddin M, Gomez D' Aza DJ, Pokhrel A, Manvar K, Wang JC. Recurrent Left Renal Fossa Clear Cell Renal Cell Carcinoma With Pancreatic Tail Invasion Presenting as Intestinal Obstruction. Cureus 2023; 15:e47953. [PMID: 38034254 PMCID: PMC10685987 DOI: 10.7759/cureus.47953] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2023] [Indexed: 12/02/2023] Open
Abstract
Distant renal cell carcinoma (RCC) metastatic disease is mostly seen in the lungs, bones, and lymph nodes. The incidence of local recurrences within the ipsilateral retroperitoneum (RFR) is very low. We report a case of a 79-year-old male with recurrent left renal fossa RCC with pancreatic tail invasion who presented with large bowel obstruction. To the best of our knowledge, no cases have been reported of recurrent left renal fossa RCC initially presenting as extrinsic large bowel obstruction.
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Affiliation(s)
- Mustafa Wasifuddin
- Internal Medicine, Brookdale University Hospital Medical Center, Brooklyn, USA
| | | | - Akriti Pokhrel
- Internal Medicine, Brookdale University Hospital Medical Center, Brooklyn, USA
| | - Kapilkumar Manvar
- Hematology and Medical Oncology, Brookdale University Hospital Medical Center, Brooklyn, USA
| | - Jen Chin Wang
- Hematology and Oncology, Brookdale University Hospital Medical Center, Brooklyn, USA
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Barros P, Oliveira B, Pereira R, Dores M, Coutinho A. Small Bowel Intussusception Secondary to Metastatic Renal Cell Carcinoma: A Case Report. Cureus 2023; 15:e44431. [PMID: 37791227 PMCID: PMC10543932 DOI: 10.7759/cureus.44431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2023] [Indexed: 10/05/2023] Open
Abstract
Bowel intussusception is rare in adults and is usually driven by an underlying pathological process affecting the bowel. Renal cell carcinoma (RCC) is the most common type of kidney cancer and its disease course, depending on the initial histology and disease stage, can metastasize to adrenal glands, lungs, bones, brains and contralateral kidney that can be challenging to follow. We present the case of a patient with a history of radical left nephrectomy for RCC that developed an acute bowel obstruction, secondary to an ileal metastasis of RCC. In previous surgeries, small bowel obstruction (SBO) is usually found due to adhesions, nonetheless in a patient with a history of high-grade disease at diagnosis, one must keep in mind the possibility of disease relapse in the setting of SBO.
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Affiliation(s)
- Pedro Barros
- Urology, Centro Hospitalar Universitário do Algarve, Faro, PRT
| | - Bárbara Oliveira
- Urology, Centro Hospitalar Universitário do Algarve - Hospital de Faro, Faro, PRT
| | - Rute Pereira
- General Surgery, Centro Hospitalar Universitário do Algarve - Hospital de Faro, Faro, PRT
| | - Marco Dores
- Urology, Centro Hospitalar Universitário do Algarve - Hospital de Faro, Faro, PRT
| | - Aníbal Coutinho
- Urology, Centro Hospitalar Universitário do Algarve - Hospital de Faro, Faro, PRT
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Muacevic A, Adler JR, Hamza A, Khokhar HT, Butt M. Metastatic Jejunal Renal Cell Carcinoma Intussusception Presenting as Melena. Cureus 2022; 14:e32554. [PMID: 36654622 PMCID: PMC9840379 DOI: 10.7759/cureus.32554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2022] [Indexed: 12/23/2022] Open
Abstract
Renal cell carcinoma (RCC) most commonly metastasizes to the lungs, and it is uncommon for RCC to metastasize to the small bowel. Small bowel metastasis commonly presents with gastrointestinal (GI) bleeding. In rare cases, a metastatic small bowel mass can serve as a lead point for intussusception. In this report, we present the case of a male patient whose chief complaint was melena. The patient denied any abdominal pain or nausea. Investigation with push enteroscopy revealed a jejunal mass, and further evaluation with CT showed small bowel intussusception. The patient subsequently underwent small bowel resection and anastomosis. Histopathology confirmed that the jejunal mass was metastatic RCC. We present this case in order to showcase the utility of push enteroscopy in the diagnosis of small bowel metastasis in RCC.
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Katsoulis IE, Sourouppi C, Dafnis AN, Katsaounis D, Tsamakidis K. Small bowel intussusception due to metastatic renal cell carcinoma. J Surg Case Rep 2022; 2022:rjac156. [PMID: 35975228 PMCID: PMC9374471 DOI: 10.1093/jscr/rjac156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 03/22/2022] [Indexed: 12/02/2022] Open
Abstract
Metastases from renal cell carcinoma (RCC) are rarely located in the small bowel and usually present either with iron deficiency anaemia due to occult bleeding or obstructive symptoms. A 65-year-old man with not known malignancy was admitted to our hospital with symptoms of intermittent bowel obstruction. The abdominal computed tomography (CT) scan depicted a large tumour of the right kidney and obstruction of the small intestine at the level of the proximal jejunum. A jejuno-jejunal intussusception was found on laparotomy, due to endoluminal lesions that proved to be metastatic from RCC. Intussusception of the small bowel due to metastatic RCC is a very rare combination and only a few such cases have been reported so far in the literature.
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Affiliation(s)
- Iraklis E Katsoulis
- Correspondence address. Department of Surgical Oncology, St. Savvas Cancer Hospital, 171 Alexandra’s Avenue, 11522 Athens, Greece. Tel: 00306944747226; E-mail:
| | - Chrystalla Sourouppi
- Department of Surgical Oncology and Department of Gastroenterology, St. Savvas Cancer Hospital, 171 Alexandra’s Avenue, 11522 Athens, Greece
| | - Andreas N Dafnis
- Department of Surgical Oncology and Department of Gastroenterology, St. Savvas Cancer Hospital, 171 Alexandra’s Avenue, 11522 Athens, Greece
| | - Dionysios Katsaounis
- Department of Surgical Oncology and Department of Gastroenterology, St. Savvas Cancer Hospital, 171 Alexandra’s Avenue, 11522 Athens, Greece
| | - Klisthenis Tsamakidis
- Department of Surgical Oncology and Department of Gastroenterology, St. Savvas Cancer Hospital, 171 Alexandra’s Avenue, 11522 Athens, Greece
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Management of Adult Intussusception-A Case Series Experience from a Tertiary Center. World J Surg 2021; 45:3584-3591. [PMID: 34363099 DOI: 10.1007/s00268-021-06277-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND The management of intussusception is controversial. Clinical presentation, with the aid of imaging modalities, enables a better selection of patients for the appropriate treatment algorithm. Conservative management versus surgical intervention with bowel resection is considered accordingly. METHODS Retrospective review of a computerized database of patients who were admitted with intussusception between January 1, 2010, and December 31, 2020, in a single tertiary center in Israel. Patients who were treated conservatively were compared to those who underwent surgery. Patients who underwent bowel resection were compared to those that had surgery without a resection. RESULTS A total of 76 patients were diagnosed with intussusception, and 49 were operated. Bowel resection was performed in 32 cases. 20/76(26%) were successfully managed conservatively. Patients with a lead point (OR = 5.59) and colonic involvement (OR = 13.72) had a higher likelihood for resection. The likelihood of bowel resection was found to be significantly lower with proximal small bowel intussusception (OR = 0.071). CONCLUSION Young patients presenting with intussusception may be treated conservatively when adequate criteria are met in order to avoid unnecessary surgical interventions.
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9
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Systemic manifestations - do not forget the small bowel. Curr Opin Gastroenterol 2021; 37:234-244. [PMID: 33606400 DOI: 10.1097/mog.0000000000000717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
PURPOSE OF REVIEW Systemic diseases can afflict the small bowel (SB) but be challenging to diagnose. In this review, we aim to provide a broad overview of these conditions and to summarise their management. RECENT FINDINGS Small bowel capsule endoscopy (SBCE) is an important modality to investigate pathology in the SB. SB imaging can be complementary to SBCE for mural and extramural involvement and detection of multiorgan involvement or lymphadenopathy. Device assisted enteroscopy provides a therapeutic arm, to SBCE enabling histology and therapeutics to be carried out. SUMMARY SB endoscopy is essential in the diagnosis, management and monitoring of these multi-system conditions. Collaboration across SB centres to combine experience will help to improve the management of some of these rarer SB conditions.
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Severe Small Bowel Bleeding Associated With Metastatic Clear Cell Renal Cell Carcinoma to the Jejunum. ACG Case Rep J 2020; 7:e00397. [PMID: 32637441 DOI: 10.14309/crj.0000000000000397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 03/19/2020] [Indexed: 11/17/2022] Open
Abstract
Clear cell renal cell carcinoma is a malignancy of the kidneys that most commonly metastasizes to lung, bone, lymph nodes, liver, adrenal glands, and brain. We present a 75-year-old man with severe and chronic gastrointestinal bleeding who was eventually discovered to have clear cell renal cell carcinoma metastatic to his jejunum as the source of his bleed. This is a rare phenomenon and an unusual cause of gastrointestinal bleeding.
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Diaz de Leon A, Pirasteh A, Costa DN, Kapur P, Hammers H, Brugarolas J, Pedrosa I. Current Challenges in Diagnosis and Assessment of the Response of Locally Advanced and Metastatic Renal Cell Carcinoma. Radiographics 2019; 39:998-1016. [PMID: 31199711 DOI: 10.1148/rg.2019180178] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Locally advanced and metastatic renal cell carcinoma (RCC) present a specific set of challenges to the radiologist. The detection of metastatic disease is confounded by the ability of RCC to metastasize to virtually any part of the human body long after surgical resection of the primary tumor. This includes sites not commonly included in routine surveillance, which come to light after the patient becomes symptomatic. In the assessment of treatment response, the phenomenon of tumor heterogeneity, where clone selection through systemic therapy drives the growth of potentially more aggressive phenotypes, can result in oligoprogression despite overall disease control. Finally, advances in therapy have resulted in the development of immuno-oncologic agents that may result in changes that are not adequately evaluated with conventional size-based response criteria and may even be misinterpreted as progression. This article reviews the common challenges a radiologist may encounter in the evaluation of patients with locally advanced and metastatic RCC. ©RSNA, 2019.
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Affiliation(s)
- Alberto Diaz de Leon
- From the Department of Radiology (A.D.d.L., A.P., D.N.C., I.P.), Advanced Imaging Research Center (D.N.C., I.P.), Department of Pathology (P.K.), Department of Urology (P.K.), Kidney Cancer Program-Simmons Comprehensive Cancer Center (P.K., H.H., J.B., I.P.), and Department of Internal Medicine (H.H., J.B.), UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390
| | - Ali Pirasteh
- From the Department of Radiology (A.D.d.L., A.P., D.N.C., I.P.), Advanced Imaging Research Center (D.N.C., I.P.), Department of Pathology (P.K.), Department of Urology (P.K.), Kidney Cancer Program-Simmons Comprehensive Cancer Center (P.K., H.H., J.B., I.P.), and Department of Internal Medicine (H.H., J.B.), UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390
| | - Daniel N Costa
- From the Department of Radiology (A.D.d.L., A.P., D.N.C., I.P.), Advanced Imaging Research Center (D.N.C., I.P.), Department of Pathology (P.K.), Department of Urology (P.K.), Kidney Cancer Program-Simmons Comprehensive Cancer Center (P.K., H.H., J.B., I.P.), and Department of Internal Medicine (H.H., J.B.), UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390
| | - Payal Kapur
- From the Department of Radiology (A.D.d.L., A.P., D.N.C., I.P.), Advanced Imaging Research Center (D.N.C., I.P.), Department of Pathology (P.K.), Department of Urology (P.K.), Kidney Cancer Program-Simmons Comprehensive Cancer Center (P.K., H.H., J.B., I.P.), and Department of Internal Medicine (H.H., J.B.), UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390
| | - Hans Hammers
- From the Department of Radiology (A.D.d.L., A.P., D.N.C., I.P.), Advanced Imaging Research Center (D.N.C., I.P.), Department of Pathology (P.K.), Department of Urology (P.K.), Kidney Cancer Program-Simmons Comprehensive Cancer Center (P.K., H.H., J.B., I.P.), and Department of Internal Medicine (H.H., J.B.), UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390
| | - James Brugarolas
- From the Department of Radiology (A.D.d.L., A.P., D.N.C., I.P.), Advanced Imaging Research Center (D.N.C., I.P.), Department of Pathology (P.K.), Department of Urology (P.K.), Kidney Cancer Program-Simmons Comprehensive Cancer Center (P.K., H.H., J.B., I.P.), and Department of Internal Medicine (H.H., J.B.), UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390
| | - Ivan Pedrosa
- From the Department of Radiology (A.D.d.L., A.P., D.N.C., I.P.), Advanced Imaging Research Center (D.N.C., I.P.), Department of Pathology (P.K.), Department of Urology (P.K.), Kidney Cancer Program-Simmons Comprehensive Cancer Center (P.K., H.H., J.B., I.P.), and Department of Internal Medicine (H.H., J.B.), UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390
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Sadhale A, Adike A, Lam-Himlin D. Metastatic renal cell carcinoma presenting with melena. Clin Case Rep 2018; 6:961-962. [PMID: 29744101 PMCID: PMC5930209 DOI: 10.1002/ccr3.1492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 01/16/2018] [Accepted: 02/24/2018] [Indexed: 11/09/2022] Open
Abstract
Renal cell carcinoma is a highly malignant neoplasm. Metastasis to the pancreas and gastrointestinal tract is rare. In this case report, we show images of metastatic renal cell carcinoma to the upper gastrointestinal tract in a patient who presented with melena.
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Affiliation(s)
- Ashwini Sadhale
- Department of Gastroenterology and Hepatology Mayo Clinic Scottsdale Arizona
| | - Abimbola Adike
- Department of Gastroenterology and Hepatology Mayo Clinic Scottsdale Arizona
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van Peer S, van de Ven C, Terwisscha van Scheltinga C, Hol J, Wijnen M, Littooij A, van Grotel M, van den Heuvel-Eibrink M. The unique characteristics of intussusception after renal tumor surgery in children. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2018. [DOI: 10.1016/j.epsc.2017.12.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Metastatic renal cell carcinoma to the small bowel: three cases of GI bleeding and a literature review. CEN Case Rep 2017; 7:39-43. [PMID: 29185198 DOI: 10.1007/s13730-017-0288-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 11/16/2017] [Indexed: 12/15/2022] Open
Abstract
Approximately 25-30% of patients with renal cell carcinoma (RCC) have metastatic disease at the time of diagnosis, where the most common sites of metastasis are the lung (50-60% of patients with metastatic disease), bones (30-40%), liver (30-40%), and brain (5%). Although RCC metastasis to the small intestine is thought to be exceedingly rare, with predominantly isolated case reports and a few case series in the literature, we present below three additional cases at our institution of metastatic RCC to the small bowel presenting as GI bleeding. A literature review demonstrates that the number of published case reports has been increasing in recent years. We hypothesize that in the era of targeted chemotherapy and VEGF inhibitors to treat RCC that patients are living longer and have more time for their primary tumors to metastasize to the small bowel and become symptomatic, causing metastatic RCC to the small bowel to be less rare than previously thought.
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