Gastric and esophageal metastases in renal cell carcinoma: systematic review and management options

Cabezas-Camarero, Santiago; Puente, Javier; Manzano, Aránzazu; Ayala, Eduardo; Callata, Hector R; Rosa, C. Aguado de la; González-Larriba, José-Luis; Sotelo, Miguel; Dı́az-Rubio, Eduardo

doi:10.1007/s13691-014-0202-6

Cited by 4 publications

(9 citation statements)

References 73 publications

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“…RCC metastasis after resection of primary cancer has been reported to occur in the pancreas, gastric mucosa, and duodenum. Esophageal metastasis from RCC is very rare, and has been reported after resection of primary RCC [ 1 , 2 ]. A search of the PubMed database did not reveal prior publication of diagnosis of renal cell metastasis to GEJ, established prior to diagnosis of primary RCC.…”

Section: Introductionmentioning

confidence: 99%

Rare presentation of renal cell cancer as dysphagia: a case report

Padda¹,

Mao

2019

J Med Case Reports

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BackgroundMetastasis from distal solid organs to the esophagus is very rare. Renal cell cancer with esophageal metastasis is extremely rare. We present the first case report of undiagnosed renal cell cancer presenting as dysphagia.Case presentationA 56-year-old Caucasian man presented for dysphagia evaluation. An esophagogastroduodenoscopy examination revealed a 6 mm nodule located at gastroesophageal junction. Pathology and immunohistopathology were suggestive of metastatic renal cell cancer. Abdominal imaging revealed a large renal mass consistent with renal cell cancer. He underwent left nephrectomy and is clinically asymptomatic, while being monitored by Oncology and Urology.ConclusionsUndiagnosed renal cell cancer metastasis presenting as dysphagia is very rare. Careful upper endoscopy examination contributed to the diagnosis of this rare entity. A multidisciplinary team approach is key for management of these clinical dilemmas.

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Section: Introductionmentioning

confidence: 99%

Rare presentation of renal cell cancer as dysphagia: a case report

Padda¹,

Mao

2019

J Med Case Reports

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“…Our study is, to the best of our knowledge, the largest monocentric study providing the prevalence of RCC metastasis throughout the digestive tract. Studies in the literature on RCC metastasis in the digestive tract are mainly case reports of 1 to 5 cases ( 11 – 23 ) or literature reviews ( 3 , 9 , 24 – 31 ). One of the limitations of this study is the single center design which limits the number of patients.…”

Section: Discussionmentioning

confidence: 99%

“…About the treatment, Cabezas-Camarero et al have proposed recommendations for the therapeutic management of gastric metastases of RCC ( 24 ). Endoscopic mucosal resection or endoscopic submucosal dissection appears to have a place in the management of small, single lesions ( 28 ).…”

Section: Discussionmentioning

confidence: 99%

Gastrointestinal Metastases From Primary Renal Cell Cancer: A Single Center Review

et al. 2021

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Introduction: Digestive metastases (DMs) from renal cell cancer (RCC) are rare. Over the past decade, the overall survival of metastatic RCC (mRCC) has been improved by tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors. The main objective of this study was to assess the incidence of metastases of the digestive tract in this new field of treatment. The secondary objectives were to evaluate the clinical characteristics, prognosis, treatments used for DMs, and median time between the diagnosis of RCC or mRCC and DMs.Materials and Methods: A retrospective analysis of data collected from all patients with mRCC between 2007 (the time of TKI was a standard of care) and 2019 was carried out at the Paoli-Calmettes Institute (Marseille, France). Computer research software using artificial intelligence (ConSoRe®) was used to identify patients and assess their characteristics.Results: Between January 2007 and December 2019, 11 out of 660 (1.6%) mRCC patients had metastases of the gastrointestinal tract. The median age was 62 years. Of the 11 patients, 81.8% experienced digestive bleeding or anemia. Only 2 patients were asymptomatic. The metastases were mainly duodenal (50%) and gastric (41.6%). The median time from cancer diagnosis and from metastatic disease to gastrointestinal metastasis was 4.3 years (3 months−19.2 years) and 2.25 years (0 days−10.2 years), respectively. Local treatment was performed in 38.5% of cases by endoscopy (60%), surgery (20%) and radiotherapy (40%) with success rates of 33, 100, and 50%, respectively. Etiological treatment was modified following the discovery of DM in 84.6% of the cases. The median survival was 1 year from the diagnosis of DM (13 days−9.4 years). Two patients were still alive 2.9 and 9.4 years after the diagnosis of DM.Conclusion: This is the largest monocentric retrospective analysis of DM in patients with RCC. It seems to be a rare and late event in the course of the disease. Local treatment combined with systemic treatment could improve survival. In the context of prolonged survival with the new based immunotherapy treatments in mRCC, we suggest that unexplained anemia or persistent digestive symptoms could be explored by endoscopy.

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“…Its reported primary tumor types are breast cancer (27%), lung cancer (23%), RCC (7.6%), and malignant melanoma (7%) [5,6]. Among the various possible metastatic sites from RCC, the stomach has only rarely been reported [8][9][10][11][12][13][14]. Cabezas-Camerero et al reviewed 62 cases of gastric metastases from renal cell carcinoma [8].…”

Section: Discussionmentioning

confidence: 99%

“…Among the various possible metastatic sites from RCC, the stomach has only rarely been reported [8][9][10][11][12][13][14]. Cabezas-Camerero et al reviewed 62 cases of gastric metastases from renal cell carcinoma [8]. Median age at diagnosis of gastric metastasis was 66.5 years (range 38-87 years) with a male-to-female ratio of 45:17.…”

Section: Discussionmentioning

confidence: 99%

A case of gastric metastasis from renal cell cancer during the sequential targeted therapy

et al. 2017

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Historically, gastric metastasis from renal cell cancer (RCC) has been extremely rare. As RCC is now being treated with various agents of targeted therapy, however, the rate of unusual visceral metastases might increase as outcomes improve and follow-up periods grow longer. Here we present a valuable case of gastric metastasis from RCC detected in a routine CT scan during sequential targeted therapy. A 73-year-old man was referred to our hospital, presenting with left renal cell cancer with multiple lung metastases at stage cT1bN0M1. He received first-line targeted therapy consisting of sunitinib and subsequently underwent left radical nephrectomy. He then underwent sequential therapy consisting of interferon-alpha, sunitinib, everolimus, and axitinib for multiple lung metastases. Five years after nephrectomy, a follow-up computed tomography scan revealed a 2.2 × 1.6 cm mass in the stomach without any symptoms. Gastrointestinal endoscopy disclosed a polypoid lesion at the gastric fundus. Endoscopic submucosal resection was performed. Microscopic diagnosis revealed gastric metastasis from RCC. As various new therapeutic agents increase survival periods for metastatic RCC patients in this era of targeted therapy, clinicians must watch for metastasis in the stomach, though this was formerly a rare event.

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Gastric and esophageal metastases in renal cell carcinoma: systematic review and management options

Cited by 4 publications

References 73 publications

Rare presentation of renal cell cancer as dysphagia: a case report

Rare presentation of renal cell cancer as dysphagia: a case report

Gastrointestinal Metastases From Primary Renal Cell Cancer: A Single Center Review

A case of gastric metastasis from renal cell cancer during the sequential targeted therapy

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