[Gastrointestinal hemorrhage due to jejunal metastases from kidney cancer]

Severe blood loss anaemia and recurrent intussusceptions as first presentation of bowel metastatic renal cell carcinoma: A case report and review of the literature

Renal cell carcinoma (RCC) may metastasize to almost any organ, but bowel metastases are highly unusual. A 75-year-old man presented with symptoms and signs of severe anaemia due to bowel bleeding and abdominal pain due to recurrent bowel intussusception. The patient underwent surgery and was identified to have intraluminal metastases from metastatic RCC. To the best of our knowledge, few cases of metastases from RCC manifesting as synchronous intraluminal polypoid tumours have been described in the literature. The present report focused on the importance of two aspects that must be considered: The role of accurate diagnosis and of surgery treating intestinal metastases that may lead to symptom control and prolonged survival.

Solitary jejunal metastasis from renal cell carcinoma presenting as small bowel obstruction 19 years after nephrectomy

Metachronous metastatic disease may develop in up to 50% of patients with renal cell carcinoma (RCC) who have undergone a presumably curative radical nephrectomy. We describe a case of small bowel obstruction secondary to a solitary jejunal RCC metastasis affecting a 66-year-old man with a history of RCC, which was treated 19 years earlier by right radical nephrectomy. The patient underwent successful laparotomy and wide margin resection of the affected small bowel with end-to-end anastomosis. A subsequent staging CT revealed no other metastases. To our knowledge, only eight cases of isolated small bowel metastasis from RCC have been reported. Of these, only one previous report referred to a longer time interval to small bowel metastasis than our case. The case highlights that isolated bowel metastasis should be considered as a possible aetiology of small bowel obstruction, even in patients with a distant history of presumably curative cancer treatment.

Multiple intussusceptions revealing metastases from renal carcinoma to the small intestine

Malignant tumors of the kidney represent rare primary intestinal metastases. They occur in 4% of cases. These intestinal metastases are mainly the small intestine; colon is a rare achievement. We report a case of small intestine metastatic of a tubulo-pappilary carcinoma revealed by a multiple intussusception a year after nephrectomy. The cross-sectional imaging (ultrasound and CT) was the gold standard for positive diagnosis of intussusception and the nature of secondary underlying tumor. Intestinal metastases of renal cell carcinoma sometimes occur many years after nephrectomy. On imaging, metastases simulate all tumor aspects.