Sheng-Rui Yang1,2, Wen-Liang Fang3,4, Anna Fen-Yau Li4,5 and Kuo-Hung Huang3,4*
1Department of Surgery, Division of General Surgery, Tao-Yuan General Hospital, Taiwan 2 School of Medicine, National Defense Medical Center, Taiwan 3 Department of Surgery, Division of General Surgery, Taipei Veterans General Hospital, Taiwan 4 School of Medicine, National Yang-Ming University, Taiwan 5 Department of Pathology, Taipei Veterans General Hospital, TaiwanFulltext PDF
Gastrointestinal (GI) metastases from Renal Cell Carcinoma (RCC) are rare. RCC with GI tract metastasis generally manifests with bleeding and obstruction, but RCC with small-bowel metastases-related intussusception accompanied by multiple GI tract involvement is an extremely rare pathology. A 62-year-old woman presented to our hospital with melena and anemia caused by GI bleeding and recent acute abdominal pain with obstruction. Abdominal ultrasound and computed tomography revealed small-bowel intussusception and stomach polyp. The patient was diagnosed with RCC with lung and brain metastases and subsequently underwent gamma knife radiosurgery and sunitinib therapy. Intraoperative findings included a 3 ? 3 cm2 intramural mass 50 cm distal to the Treitz ligament, determined to be the leading point of the intussusception, two other small-bowel lesions with intramural polypoid masses, and serosa erosion distal to the ileocecal valve (40 cm and 100 cm, respectively). Three small-bowel segmental resections with endto-end anastomosis were performed. The postoperative course was uneventful. Pathologic results confirmed the diagnosis of metastatic RCC. RCC with small-bowel metastases is relatively rare. Most small intestinal metastases are associated with malignant melanomas. However, GI tract metastasis may occur in patients with a known history of RCC who present with GI symptoms and signs. Our patient presented with small-bowel intussusception and stomach polypoid. The final pathology revealed stomach and small-bowel metastases and clear cell-type RCC. This is an unusual finding among cases of bowel metastasis from RCC reported in the literature from 2006 to the present.
Gastrointestinal metastases; Gamma knife radiosurgery; Renal cell carcinoma; Small-bowel; Metastases, Small-bowel intussusception; Stomach polyp
Yang S-R, Fang W-L, Fen-Yau Li A, Huang K-H. Multiple Gastrointestinal Metastases, Small-Bowel Intussusception, and Stomach Polyps in Advanced Renal Cell Carcinoma: A Case Report and Literature Review. Clin Surg. 2021; 6: 3026..