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

Abstract

BackgroundRenal 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 presentationA 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.ConclusionThe 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.

Canine Intestinal Lymphangiectasia Concomitant with Renal Cell Carcinoma

“…Though RCC does not have a propensity for gastrointestinal metastasis, there are several reports of its metastasis to the gastrointestinal tracts in humans [21,22].Third, apart from physical compression or embolus formation from metastasis, RCCs may attribute to the incidence of IL, which is associated with either the functional alteration of kidney or pathological conditions due to the RCC itself. Albeit uncommon, it has been reported that RCC can be associated to gastrointestinal diseases [23]. RCC is associated with gastrointestinal symptoms such as pain, gastritis, and hiatus hernia [23].…”

“…Albeit uncommon, it has been reported that RCC can be associated to gastrointestinal diseases [23]. RCC is associated with gastrointestinal symptoms such as pain, gastritis, and hiatus hernia [23]. Additionally, other renal diseases such as hemolytic uremic syndrome have been associated with the incidence of IL [24].…”

Sarcomatoid renal cell carcinoma with clear cells and eosinophilia: a case report and short review of the literature

“…The incidence of kidney cancer varies across countries. Kidney cancer is most common diagnosed in people over 75 years old with the highest rates of diagnosis between 85 to 89 years old for both males and females [ 1 , 2 ]. Renal cell carcinoma (RCC), also known as hypernephroma, is currently the most common type of renal tumor found in adults aged between 50 to 70 years old [ 3 ].…”