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. 2015:15:130-2.
doi: 10.1016/j.ijscr.2015.08.011. Epub 2015 Aug 13.

An obscure cause of gastrointestinal bleeding: Renal cell carcinoma metastasis to the small bowel

Robyn L Gorski  1 , Salah Abdel Jalil  2 , Manver Razick  3 , Ala' Abdel Jalil  4
Affiliations

An obscure cause of gastrointestinal bleeding: Renal cell carcinoma metastasis to the small bowel

Robyn L Gorski et al. Int J Surg Case Rep. 2015.

Abstract

Renal cell carcinoma metastasis to the small intestine is a rare condition. It usually results in gastrointestinal bleeding and it could happen many years after the diagnosis with renal cell cancer. Treatment includes surgery as well as targeted agents such as tyrosine kinases. We report here the case of an 82-year-old man with a past medical history of high-grade renal cell carcinoma and right nephrectomy 6 years earlier, who presented with recurrent episodes of syncope and black stools. He underwent esophagogastroduodenoscopy (EGD) and colonoscopy without evident source of bleeding. Video capsule endoscopy (VCE) showed three bleeding lesions in the jejunum and ileum. Push enteroscopy revealed a proximal jejunum bleeding mass that was suspicious for malignancy. Histopathology demonstrated poorly differentiated carcinoma. Given the patient's history of high-grade renal cell carcinoma, and similarity of histologic changes to the old renal cell cancer specimen, metastatic renal cell carcinoma was felt to be the responsible etiology.

Keywords: Bleeding; Metastases; Push enteroscopy; Renal cell carcinoma; Small bowel; Video capsule endoscopy.

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Figures

Fig. 1
Fig. 1
Video capsule endoscopy showing blush of blood in proximal jejunum.
Fig. 2
Fig. 2
Push enteroscopy showing an irregular-shaped, raised bleeding mass in proximal jejunum.
Fig. 3
Fig. 3
Microscopic image (40×) of the small bowel lesion showing poorly differentiated carcinoma.
Fig. 4
Fig. 4
Microscopic image (40×) of the resected kidneymass 6 years earlier, showing clear cell carcinoma.
See this image and copyright information in PMC

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