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Trojaniello C, Vitale MG, Trojaniello B, Lentini Graziano ML, Coccaro M, Cartenì G, Montesarchio V. Severe blood loss anaemia and recurrent intussusceptions as first presentation of bowel metastatic renal cell carcinoma: A case report and review of the literature. Mol Clin Oncol 2017; 7:654-660. [PMID: 28855999 DOI: 10.3892/mco.2017.1365] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Accepted: 02/14/2017] [Indexed: 11/06/2022] Open
Abstract
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.
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Affiliation(s)
- Claudia Trojaniello
- Oncology Unit, Azienda Ospedaliera dei Colli, Ospedale Monaldi, I-80131 Naples, Italy
| | - Maria Giuseppa Vitale
- UOSC Oncologia Medica, Azienda Ospedaliera di Rilievo Nazionale 'Antonio Cardarelli', I-80131 Naples, Italy
| | - Biagio Trojaniello
- U.O. Urgenze Chirurgiche ed Accettazione Generale, Ospedale San Paolo ASL Napoli 1 Centro, I-80131 Naples, Italy
| | | | - Mariarosa Coccaro
- Oncology Unit, Azienda Ospedaliera dei Colli, Ospedale Monaldi, I-80131 Naples, Italy
| | - Giacomo Cartenì
- UOSC Oncologia Medica, Azienda Ospedaliera di Rilievo Nazionale 'Antonio Cardarelli', I-80131 Naples, Italy
| | - Vincenzo Montesarchio
- Oncology Unit, Azienda Ospedaliera dei Colli, Ospedale Monaldi, I-80131 Naples, Italy
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Ismail I, Neuen BL, Mantha M. Solitary jejunal metastasis from renal cell carcinoma presenting as small bowel obstruction 19 years after nephrectomy. BMJ Case Rep 2015; 2015:bcr-2015-210857. [PMID: 26370628 DOI: 10.1136/bcr-2015-210857] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
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.
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Affiliation(s)
- Ibrahim Ismail
- Department of Nephrology, Gold Coast University Hospital, Gold Coast, Queensland, Australia
| | | | - Murty Mantha
- Department of Nephrology, Cairns Hospital, Cairns, Queensland, Australia
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Mishra S, Hazra SP, Priyadarshi V, Goel H, Pal DK. Synchronous Jejunal Metastasis Presenting as Intussusception in a Case of Advanced RCC: a Rare Presentation. Indian J Surg 2013; 77:59-61. [PMID: 25829714 DOI: 10.1007/s12262-013-1009-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Accepted: 11/15/2013] [Indexed: 12/27/2022] Open
Abstract
Renal cell carcinoma (RCC) may metastasize to almost any organ, but metastasis to the small bowel is very rare. Factors responsible for a resistant behavior of small bowel wall are still not clear. Small bowel metastasis from RCC may cause obstruction, bleeding, and perforation. RCC metastasis to the small bowel presenting as intussusception is extremely rare. Only 20 cases of small bowel intussusceptions caused by metastatic RCC have been reported worldwide. Here, we are reporting this rare case of RCC with simultaneous solitary metastasis in jejunum which presented as intussusceptions and which was treated with simultaneous radical nephrectomy, jejunal resection, and anastomosis.
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Affiliation(s)
- Shwetank Mishra
- Department of Urology, I.P.G.M.E.&R. and S.S.K.M. Hospital, 244, A.J.C. Bose Road, Kolkata, 700020 India
| | - Shankar Prasad Hazra
- Department of Urology, I.P.G.M.E.&R. and S.S.K.M. Hospital, 244, A.J.C. Bose Road, Kolkata, 700020 India
| | - Vinod Priyadarshi
- Department of Urology, I.P.G.M.E.&R. and S.S.K.M. Hospital, 244, A.J.C. Bose Road, Kolkata, 700020 India
| | - Hemant Goel
- Department of Urology, I.P.G.M.E.&R. and S.S.K.M. Hospital, 244, A.J.C. Bose Road, Kolkata, 700020 India
| | - Dilip Kumar Pal
- Department of Urology, I.P.G.M.E.&R. and S.S.K.M. Hospital, 244, A.J.C. Bose Road, Kolkata, 700020 India
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Eo WK, Kim GY, Choi SI. A case of multiple intussusceptions in the small intestine caused by metastatic renal cell carcinoma. Cancer Res Treat 2008; 40:97-9. [PMID: 19688056 DOI: 10.4143/crt.2008.40.2.97] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2008] [Accepted: 05/25/2008] [Indexed: 01/23/2023] Open
Abstract
Renal cell carcinoma (RCC) may metastasize to almost any organ, but metastasis to the small bowel is rare. Small bowel metastasis from RCC can induce obstruction or bleeding, and perforation can also be induced in rare case. Yet RCC metastasis to the small bowel is unlikely to be a direct cause of intussusceptions. A few cases of intussusceptions caused by small intestinal metastasis of RCC have been reported, but multiple small intestinal intussusceptions are extremely rare. We report here on a 47-year-old male patient who presented to the emergency room with acute abdominal pain. He had undergone radical nephrectomy 2 years previously due to left RCC. The abdominal CT scan revealed enhanced masses with the "target" sign that suggested enteric intussusceptions in the jejunum. Eight pedunculated masses within the small intestinal lumen led to intussusceptions at 30 and 150 cm distal to Treitz ligament. Three segmental resections of the small intestine and functional end to end anastomosis were done. The patient recovered uneventfully from this operation. To the best of our knowledge, this is the 1(st) report of metastases from RCC that presented as synchronous intraluminal polypoid tumors, and these tumors served as the lead points for two intussusceptions in the jejunum.
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Affiliation(s)
- Wan Kyu Eo
- Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea.
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Sridhar SS, Haider MA, Guindi M, Moore MJ. A case of small bowel obstruction due to intraluminal metastases from metastatic renal cell cancer. Oncologist 2008; 13:95-7. [PMID: 18305052 DOI: 10.1634/theoncologist.2006-0214] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
A 71-year-old man, with a history of metastatic renal cell cancer (RCC), presented with symptoms of a small bowel obstruction with nausea, vomiting, cramps, and diarrhea. He underwent surgery and was found to have intraluminal metastases from his metastatic RCC. Intraluminal metastases are rare and usually present with obstruction, bleeding, or perforation. The mainstay of treatment remains complete surgical excision, even in the face of widely metastatic disease. Surgery not only palliates symptoms, but may also extend survival because metastatic RCC can be a very indolent and unpredictable disease. Furthermore, these patients can now be treated with a new class of antiangiogenic agents that are showing impressive response rates, which may also translate into improved overall survival.
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Affiliation(s)
- Srikala S Sridhar
- Department of Medicine, Princess Margaret Hospital, Toronto, Ontario, M5G 2M9, Canada.
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Sasaki M, Murakami Y, Takesue Y, Yokoyama Y, Morifuji M, Hayashidani Y, Koyama M, Sueda T. Double intussusceptions in the small intestine caused by metastatic renal cell carcinoma: report of a case. Surg Today 2006; 36:85-8. [PMID: 16378202 DOI: 10.1007/s00595-005-3093-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2004] [Accepted: 03/15/2005] [Indexed: 12/12/2022]
Abstract
Renal cell carcinoma (RCC) may metastasize to almost any organ, but it is unlikely to be a direct cause of intussusception. We report a case of double enteric intussusceptions caused by metastatic RCC in a 64-year-old man. The patient presented with intermittent abdominal pain and diarrhea 11 years after undergoing a radical nephrectomy. Abdominal computed tomography (CT) showed two enhanced masses with the "target" sign, suggesting enteric intussusceptions. We performed partial enterectomy, and histological examination confirmed that the tumors had originated from RCC. To our knowledge, this is the first report of metastases from RCC manifesting as synchronous intraluminal polypoid tumors serving as the lead points of two intussusceptions in the small intestine. Thus, the possibility of multiple tumor metastases in the small intestine, with or without intussusceptions, should be considered in patients with recurrent RCC.
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Affiliation(s)
- Masaru Sasaki
- Department of Surgery, Miyoshi Central Hospital, 531 Higashisakeyamachi, Miyoshi, Hiroshima 728-8502, Japan
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Chertin B, Feigin E, Rivkin L, Reinus C, Lernau O, Farkas A. Bowel Intussusception Caused by a Single Clear Cell Renal Cell Carcinoma Metastasis. Urologia 1998. [DOI: 10.1177/039156039806500423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A 70-year-old white woman presented with small bowel intussusception due to metastasis of renal cell carcinoma (RCC) acting as a leading point. The patient had undergone nephrectomy seven years previously. Metastatic work-up showed no additional metastases. Only three previously publicized cases of a similar kind were found. Intussusception brought about by a metastasis to the bowel wall is rare, but should be borne in mind.
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Affiliation(s)
- B. Chertin
- Departments of Urology, Surgery and Pathology - Shaare Zedek Medical Center - Jerusalem (Israel)
| | - E. Feigin
- Departments of Urology, Surgery and Pathology - Shaare Zedek Medical Center - Jerusalem (Israel)
| | - L Rivkin
- Departments of Urology, Surgery and Pathology - Shaare Zedek Medical Center - Jerusalem (Israel)
| | - C. Reinus
- Departments of Urology, Surgery and Pathology - Shaare Zedek Medical Center - Jerusalem (Israel)
| | - O. Lernau
- Departments of Urology, Surgery and Pathology - Shaare Zedek Medical Center - Jerusalem (Israel)
| | - A. Farkas
- Departments of Urology, Surgery and Pathology - Shaare Zedek Medical Center - Jerusalem (Israel)
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