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Case Reports
. 2017 Winter;17(4):417-420.

Sigmoid Colonic Polyp as Initial Presentation of Metastatic Papillary Renal Cell Carcinoma

Andrew C Berry  1 , Rahman Nakshabendi  2 , Ozdemir Kanar  3 , Wayne Cai  4 , Mohan Persaud  5
Affiliations
Case Reports

Sigmoid Colonic Polyp as Initial Presentation of Metastatic Papillary Renal Cell Carcinoma

Andrew C Berry et al. Ochsner J. 2017 Winter.

Abstract

Background: Upon initial presentation, 25%-30% of patients with renal cell carcinoma have metastatic disease. Metastasis to the gastrointestinal tract is rare, but when it occurs, the large bowel is the least common site.

Case report: A 75-year-old white male presented with vague abdominal symptoms and worsening hemoglobin and hematocrit levels. Colonoscopy revealed a polyp in the distal portion of the sigmoid colon. Histologic and immunohistochemical analysis suggested metastatic papillary renal cell carcinoma.

Conclusion: To the best of our knowledge, this patient had a rare case of metastatic papillary renal cell carcinoma that metastasized to the colon and presented as a colon polyp.

Keywords: Colonic polyps; neoplasm metastasis; renal cell carcinoma.

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Figures

Figure 1.
Figure 1.
A semipedunculated 0.3-cm polyp in the distal portion of the sigmoid colon found via colonoscopy.
Figure 2.
Figure 2.
Sigmoid colon polyp: (A) H&E stain of colonic sigmoid polyp mucosa; (B) IHC stain positive for CAM 5.2; (C) IHC stain positive for PAX8; (D) IHC stain negative for CDX2. H&E, hematoxylin and eosin; IHC, immunohistochemical.
Figure 3.
Figure 3.
Right gluteal mass: (A) IHC stain positive for PAX2; (B) IHC stain positive for epithelial membrane antigen (EMA); (C) IHC stain positive for CK7. IHC, immunohistochemical.
Figure 4.
Figure 4.
Computed tomography of the abdomen with contrast demonstrates 3 masses in the right kidney, the largest measuring 3.8 cm at its greatest dimension, and 1 mass in the left kidney measuring 1.6 cm at its greatest dimension, all of which have calcifications and do not measure simple fluid density.
See this image and copyright information in PMC

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