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Case Reports
. 2018 Nov 27:11:345-348.
doi: 10.2147/IMCRJ.S178816. eCollection 2018.

Renal cell carcinoma presenting as nonspecific gastrointestinal symptoms: a case report

Utkarsh Ojha  1 , Vinod Ojha  2
Affiliations
Case Reports

Renal cell carcinoma presenting as nonspecific gastrointestinal symptoms: a case report

Utkarsh Ojha et al. Int Med Case Rep J. .

Abstract

Background: Renal cell carcinoma (RCC) arises from the renal epithelium and accounts for more than 90% of kidney cancers. RCC has a diverse range of clinical manifestations. The classical triad of loin pain, hematuria and abdominal mass is only present in 4%-17% of cases. Here, we demonstrate a unique case of RCC presenting as upper gastrointestinal (GI) symptoms without any specific GI involvement.

Case presentation: A 49-year-old man, presented with ongoing severe heartburn, nausea and vomiting for 5 months. The patient further complained of weight loss over the last 2 months. Routine blood tests were normal except raised C-reactive protein and ALP. Examination revealed a large and tender liver, and he was subsequently referred under the upper GI cancer pathway. Esophagogastroduodenoscopy showed hiatus hernia and gastritis. CT scan revealed an 11 and 9 mm nodule in the left and right lung, respectively. There was a further metastatic 13×7 cm2 mass in the liver and 10×8 cm2 mass arising from the upper pole of the left kidney with convincing evidence of tumor thrombus in left renal vein. The patient was promptly referred under the care of the oncologist team and died within months.

Conclusion: The classical triad of loin pain, hematuria and abdominal mass for RCC is not that common and RCC should be suspected in patients complaining of upper GI pain with nonspecific symptoms. Furthermore, it is not necessary that patients complaining of "heartburn" have a GI cause, as pathology in other thoracic organs present in a similar manner.

Keywords: gastrointestinal; kidney cancer; metastasis; renal cell carcinoma.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Abdomen–pelvis CT scan showing left renal mass encroaching the left renal vein. Notes: Metastatic deposits in the liver are also present. The red arrow points to the carcinoma in the left kidney.
Figure 2
Figure 2
Abdomen–pelvis CT scan showing metastasis in left lung base. Notes: The red arrow points to a mass in the left lung- which is the metastasis from the kidney.
See this image and copyright information in PMC

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