Are gastric metastases of renal cell carcinoma really rare? A case report and systematic review of the literature

Prudhomme, Thomas; Maulat, Charlotte; Péré, Guillaume; Mokrane, Fatima-Zohra; Soulié, M.; Muscari, Fabrice

doi:10.1016/j.ijscr.2021.105867

Cited by 6 publications

(14 citation statements)

References 37 publications

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“…Compared with metachronous gastric metastasis, patients with synchronous gastric metastasis had shorter median survival, suggesting a poor prognosis. Our data were in consistent with that reported in several other studies [21,24,51,85,86] from different countries where it was reported that the median interval range was 6.3 to 8.5 years and the median survival was 19 months. It can be seen that the time to gastric metastasis of RCC was long after treatment of the primary tumor.…”

Section: Discussionsupporting

confidence: 93%

“…e optimal treatment for RCC patients with gastric metastasis remains unclear, and the treatment measures taken are different according to the status of gastric metastasis. Endoscopic or surgical treatment can be used for single and early gastric metastasis [24]. Immunotherapy and/or targeted therapy can be used for multiple focal metastases or other organ metastases to improve patient survival [87][88][89][90].…”

Section: Discussionmentioning

confidence: 99%

“…We identified 73 cases of RCC with gastric metastasis from literature reviews. Including the patient treated in our hospital, there were 5 cases of RCC with simultaneous solitary gastric metastasis [4,[16][17][18][19] (Table 1), 4 cases with gastric and multiple-site metastases [20][21][22][23] (Table 2), 21 cases with solitary metachronous gastric metastasis [16,[24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42] (Table 3), and 44 cases with metachronous gastric and multiple-site metastases [32, (Table 4).…”

Section: Literature Reviewmentioning

confidence: 99%

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Application of 18F Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography in Monitoring Gastric Metastasis and Cancer Thrombi from Renal Cell Carcinoma

Xiong

Zhang

Zhou

et al. 2022

Journal of Oncology

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Background. Renal cell carcinoma (RCC) with gastric metastasis is rare, particularly accompanied by multiple cancer thrombi. Methods. We reported a 66-year-old man with a history of a right radical nephrectomy because of RCC. The patient underwent 18F prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) scanning after 6 months of targeted therapy because of gastric metastasis and cancer thrombi. We conducted a systematic review of the literature and identified 73 cases of RCC with gastric metastasis. We analyzed the clinicopathological characteristics, therapies, and outcomes of patients. Results. 18F-PSMA PET/CT showed a large mass in the gastric fundus and cancer thrombi in the right atrium, inferior vena cava, and splenic vein with intense tracer uptake. Other metastases with increased tracer uptake included multiple bones and abdominal lymph nodes. The majority of gastric metastasis of RCC were men (53/73, 72.6%), with a median age at presentation of 67 (from 48 to 87) years. Gastric metastasis of RCC was mainly metachronous, and presented with small polyps or mass appearance and often accompanied by multiple-site metastases and gastrointestinal symptoms. An overall median interval between nephrectomy and diagnosis of gastric metastasis was 6 (from 0.1 to 23) years, and an overall median survival time was 14 (from 0.25 to 72) months. The median interval time of solitary gastric metastasis was longer than gastric metastasis with multiple-site metastases (7 vs.5 years; P = 0.034 ). Patients with gastric and multiple-site metastases had higher mortality than patients with solitary metastasis (17 vs.1; P = 0.028 ). The patients with synchronous gastric metastasis had a shorter survival time than metachronous gastric metastasis (6 vs.17 months; P = 0.018 ). Conclusions. Postoperative follow-up of multiple imaging modalities to monitor recurrence and metastasis is necessary and important. PSMA PET/CT can improve the detection sensitivity of RCC, especially in metastatic clear cell renal cell carcinoma (ccRCC), and could provide a basis for disease staging, restaging, and therapeutic efficacy evaluation.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Literature Reviewmentioning

confidence: 99%

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Application of 18F Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography in Monitoring Gastric Metastasis and Cancer Thrombi from Renal Cell Carcinoma

Xiong

Zhang

Zhou

et al. 2022

Journal of Oncology

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“…As supported in the literature, surgical treatment remains the best therapeutic option for a solitary gastric metastasis. Many studies have even shown that median patient survival was higher after surgical treatment of gastric metastasis in the case of solitary and multiple metastatic sites [ 14 ]. Palliative gastrectomy should be an option for decreased burden on patients and the healthcare system as was for our patient.…”

Section: Discussionmentioning

confidence: 99%

Metastatic renal cell carcinoma presenting as chronic bleeding from the stomach: a rare case report

Tapasak

Mcguirt

2022

Journal of Surgical Case Reports

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Renal cell carcinoma (RCC) most commonly metastasizes to the lung, adrenals, brain and pancreas, but metastasis to the stomach is uncommon. We present a 77-year-old male who underwent left nephrectomy 9 years previously for RCC with known metastatic disease to the lungs, diaphragm and stomach, and required multiple transfusions for acute blood loss anemia. A previous esophagogastroduodenoscopy revealed a large, friable, ulcerated mass at the gastric cardia. Biopsies of the mass demonstrated clear-cell carcinoma compatible with metastatic RCC. After multiple attempts at endoscopic, procedures and embolization were unsuccessful at controlling bleeding, the patient was treated with palliative total gastrectomy with Roux-en-Y gastric bypass. At discharge, the patient had been hemodynamically stable and tolerating a liquid diet. This case report highlights the presenting symptomology of RCC, explores the rarity of gastric metastases, and reviews current literature on management strategies for these patients.

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“…The median time duration between the diagnosis of clear cell renal cell carcinoma and metachronous gastric metastasis has been reported to be 8.5 years. 7 Such a long time interval may decrease the clinical suspicion of metastatic disease and make the diagnosis even more challenging. Most of the cases with gastric metastasis are identified in autopsy studies or diagnosed by endoscopy.…”

mentioning

confidence: 99%

Gastric metastasis from renal cell carcinoma 13 years after nephrectomy

Su,

Fang

2023

J of Digest Diseases

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To the editor, Renal cell carcinoma is the most common malignant tumor of the kidneys and constitutes about 90% of all renal malignancies. 1 Renal cell carcinoma has an abundant blood supply and is thought to spread by lymphatic, hematogenous, and transcoelomic metastasis, or through direct invasion. The frequently affected sites include the lungs, bone, liver, brain and skin. Despite a high incidence of metastasis, gastric metastasis is extremely rare in renal cell carcinoma and is usually seen at the advanced stage of the disease. 2 Here we report a case of renal cell carcinoma who developed metachronous cancer metastasis to the stomach 13 years after nephrectomy.

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Are gastric metastases of renal cell carcinoma really rare? A case report and systematic review of the literature

Abstract: Highlights Solitary gastric metastasis of RCC are scarce. When feasible, surgical or endoscopic treatment of gastric metastasis should be performed. Risk of metastatic recurrence is significant and must be taken into consideration in the therapeutic strategy.

Cited by 6 publications

References 37 publications

Application of 18F Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography in Monitoring Gastric Metastasis and Cancer Thrombi from Renal Cell Carcinoma

Application of 18F Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography in Monitoring Gastric Metastasis and Cancer Thrombi from Renal Cell Carcinoma

Metastatic renal cell carcinoma presenting as chronic bleeding from the stomach: a rare case report

Gastric metastasis from renal cell carcinoma 13 years after nephrectomy

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