Multiple Gastrointestinal Metastases, Small-Bowel Intussusception, and Stomach Polyps in Advanced Renal Cell Carcinoma: A Case Report and Literature Review

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, Taiwan

^*Correspondance to: Kuo-Hung Huang 

 PDF  Full Text DOI: 10.25107/2474-1647.3026

Abstract

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.

Keywords

Gastrointestinal metastases; Gamma knife radiosurgery; Renal cell carcinoma; Small-bowel; Metastases, Small-bowel intussusception; Stomach polyp

Cite the article

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..