Rare Presentations of Metastatic Renal Cell Carcinoma with Hematochezia and Anemia
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2018, Vol 7, Issue 4
Abstract
Renal cell carcinoma (RCC) is the sixth most common cancer in men and the eighth most common cancer in women in the United States, with an estimated 65,150 new cases diagnosed in 2013 [1]. RCC’s classic presenting triad of hematuria, flank pain and palpable abdominal mass are only present in about 9 percent of patients and often, RCC is found incidentally on imaging. At diagnosis, about 16% of cases have evidence of disease in lymph nodes and 16% with distant metastases [2]. Typical sites for metastasis include lungs, bone, liver, and brain, [3] whereas intestinal metastasis is rare [4]. It is important for gastroenterologists to acknowledge the possibility of presence of metastases during endoscopy in these patients. In this case series, we present three patients with history of renal cell carcinoma with gastrointestinal metastases.A 52-year-old male with HIV and new onset iron deficiency anemia presented for further evaluation of acute blood loss anemia with hemoglobin decrease from 16 to 7.9mg/dl. Six months prior to presentation, he had EGD with LA Class B esophagitis and colonoscopy with 2 mm sigmoid polyp (biopsy with tubular adenoma). Video Capsule endoscopy showed an ulcerated lesion in distal ileum with active oozing (Figure 1A) and a non-bleeding arteriovenous malformation (Figure1B). A 1.5cm ulcerated distal ileum lesion was discovered on single balloon enteroscopy subsequently with biopsy revealing metastatic carcinoma with clear cell phenotype, with immunohistochemistry consistent with primary renal cell carcinoma. A new diagnosis of metastatic RCC was made by single balloon enteroscopy
Authors and Affiliations
Janki Patel, Niraj Patel, Denise Kalmaz
Keywords
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- EP ID EP588504
- DOI 10.26717/BJSTR.2018.07.001529
- Views 143
- Downloads 0
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