Gastric Metastasis From Renal Cell Carcinoma With Gastrointestinal Bleeding: A Case Report and Review of the Literature

Abstract

A 61-year-old man presented to our hospital with hypercalcemia and elevated C reactive protein (CRP). Evaluation revealed renal cell carcinoma (RCC) with metastasis to lung, bone, and brain. He underwent partial resection of the right kidney and a left nephrectomy. Histopathologic findings of resected tumors were consistent with clear cell RCC. Whole-brain irradiation was performed for management of brain metastasis. Postoperatively, he was treated with molecularly targeted therapy using a mammalian target of rapamycin inhibitor. Approximately 14 months later, he suffered an episode of upper gastrointestinal bleeding with secondary anemia and melena. Upper gastrointestinal endoscopy revealed a distinctly protruding lesion in the gastric body. Biopsy of the gastric lesion showed metastatic clear cell RCC. He underwent partial gastrectomy. His postoperative course was uneventful. However, 4 months after surgery, he died from brain metastasis. Metastatic RCC to the stomach, although rare, should be suspected in any patient with a history of RCC who presents with gastrointestinal symptoms.

Gastric metastasis of renal cell carcinoma 20 years after radical nephrectomy

“…[1,3] Up to now we could detect only a total of 50 cases in the literature. [1][2][3][4][5][6][7][8][9][10][11][12] In only 4 of these cases gastric metastases developed 20 or more years after diagnosis of renal cell carcinoma. [5,8,12] In this article we presented the 5 th case with gastric metastasis of renal cell carcinoma 20 years after he had undergone radical nephrectomy because of renal cell carcinoma.…”

Multiple Muscle Metastases of the Renal Cell Carcinoma After Radical Nephrectomy

“…[2][3][4][5] In our study, we report a case of RCC with metastases to the right psoas, paravertebral, and gluteus medius muscles after 4 years right side radical nephrectomy. We wish to emphasize the magnetic resonance imaging (MRI) features of metastatic RCC to the skeletal muscles.…”

“…2 Making a diagnosis of metastatic RCC to the skeletal muscle is challenging, because the site is unpredictable, in addition to it being rare, a recent review of the literature revealed some cases. [2][3][4][5] In our study, we report a case of RCC with metastases to the right psoas, paravertebral, and gluteus medius muscles after 4 years right side radical nephrectomy. We wish to emphasize the magnetic resonance imaging (MRI) features of metastatic RCC to the skeletal muscles.…”

“…The most common sites of metastatic RCC are the lungs, lymph nodes, bones, liver, adrenal glands, and brain. 1,4 In several autopsy series, about 0.4% of cases with RCC had skeletal muscle metastases. …”

“…The most common sites of metastatic RCC are the lungs, lymph nodes, bones, liver, adrenal glands, and brain. 1,4 In several autopsy series, about 0.4% of cases with RCC had skeletal muscle metastases. 2 Making a diagnosis of metastatic RCC to the skeletal muscle is challenging, because the site is unpredictable, in addition to it being rare, a recent review of the literature revealed some cases.…”