Renal cell carcinoma presenting as an upper gastrointestinal bleeding

Mohamed, Mohamed; Al-Rubaye, Sinan; Reilly, Ian; McGoldrick, Stephen

doi:10.1136/bcr-2015-211553

Cited by 5 publications

(3 citation statements)

References 8 publications

(8 reference statements)

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“…Resection of RCC metastasizing into the duodenum has been rarely described in a number of case reports. Most of these metastases were metachronous and frequently coursed with upper GI bleeding, in the same way that one of the patients included in our series [ 23 , 24 , 25 ]. Conversely, duodenal resection at the time of the radical nephrectomy has been only reported once [ 26 ].…”

Section: Discussionsupporting

confidence: 57%

Renal Cell Carcinoma with or without Tumor Thrombus Invading the Liver, Pancreas and Duodenum

González

Gaynor

Ciancio

2021

Cancers

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Background: The purpose of this study is to report the outcomes of a series of patients with locally advanced renal cell carcinoma (RCC) who underwent radical nephrectomy, tumor thrombectomy, and visceral resection. Patients and methods: 18 consecutive patients who underwent surgical treatment in the period 2003-2019 were included. Neoplastic extension was found extending into the pancreas, duodenum, and liver in 9(50%), 2(11.1%), and 7(38.8%) patients, respectively. Seven patients (38.8%) presented also inferior vena cava tumor thrombus level I (n = 3), II (n = 2), or III (n = 2). The resection was tailored according to the degree of invasiveness. Demographics, clinical presentation, disease characteristics, surgical details, 30-day postoperative complications, and overall survival (OS) were analyzed. Results: Median age was 56 years (range: 40–76). Median tumor size was 14.5 cm (range, 8.8–22), and 10 cm (range: 4–15) for those cases with pancreatico-duodenal and liver involvement, respectively. Median estimated blood loss (EBL) was 475 mL (range: 100–4000) and resulted higher for those cases requiring thrombectomy (300 mL vs. 750 mL). Nine patients (50%) required transfusions with a median requirement of 4 units (range: 2–8). No perioperative deaths were registered in the first 30 days. Overall complication rate was 44.4%. Major complications were detected in 6/18 patients (33.3%). Overall median follow-up was 24 months (range: 0–108). Five-year OS (actuarial) rate was 89.9% and 75%, for 9/11 patients with pancreatico-duodenal involvement and 6/7 patients with liver invasion, respectively. Conclusion: Our series establishes the technical feasibility of this procedure with acceptable complication rates, no deaths, and potential for durable response.

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Section: Discussionsupporting

confidence: 57%

Renal Cell Carcinoma with or without Tumor Thrombus Invading the Liver, Pancreas and Duodenum

González

Gaynor

Ciancio

2021

Cancers

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“…There are many reports of metastasis from RCC into the GI tract. Mohamed et al9 described an 80-year-old patient with RCC who presented with melena and abdominal pain. An OGD showed a bleeding polypoidal mass within the second part of the duodenum.…”

Section: Discussionmentioning

confidence: 99%

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

Ojha¹,

Ojha²

2018

IMCRJ

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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.

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“…Renal cell carcinoma (RCC) most commonly develops in the sixth and seventh decade of life and has a male preponderance 2:1 1 2. Primary RCC presenting as upper or lower gastrointestinal bleeding as a result of direct extension is uncommon with only few case reports being described in the literature 1 3–6. Metastatic spread involves haematogenous, lymphatic, transcelomic and direct invasion.…”

Section: Descriptionmentioning

confidence: 99%