title: Recurrent metastatic renal cell carcinoma presenting as a bleeding gastric ulcer after a complete response to high-dose interleukin-2 treatment.
abstract: Immunotherapy with high-dose recombinant interleukin-2 is an effective therapy for selected patients with metastatic renal cell carcinoma (RCC). Objective responses (complete or partial) are observed in about 15% of treated patients. The overall and disease-free survival of patients with a complete response are significantly prolonged. Although RCC is known to spread hematogenously, isolated RCC metastasis to the stomach is a rare event. Recurrent RCC, after a complete response to interleukin-2, presenting clinically as an isolated gastric metastasis, has not been reported to date. In this report, we describe the clinical course of a patient with metastatic RCC who had a complete response to high-dose interleukin-2 and was disease free for 4 years before presenting with massive upper gastrointestinal hemorrhage due to an isolated gastric metastasis. The patient remained disease free for 3 years after resection of the metastasis. Metastatic RCC to the stomach, although rare, should be suspected in any patient with a history of RCC who presents with gastrointestinal symptoms. In the absence of diffuse disease, aggressive therapy, including surgical resection, is appropriate for isolated gastric metastasis, because prolonged survival is possible.
authors.affiliation: Department of Surgical Oncology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
authors.forename: B
authors.initials: B
authors.lastname: Mascarenhas
authors.forename: B
authors.initials: B
authors.lastname: Konety
authors.forename: J T
authors.initials: JT
authors.lastname: Rubin
mesh_terms: D000368:Aged; D002292:Carcinoma, Renal Cell / Q000150:complications / Q000188:drug therapy / Q000556:secondary*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D007167:Immunotherapy; D007376:Interleukin-2 / Q000627:therapeutic use; D007680:Kidney Neoplasms / Q000188:drug therapy; D008175:Lung Neoplasms / Q000556:secondary / Q000628:therapy; D008297:Male; D010997:Pleural Neoplasms / Q000556:secondary / Q000628:therapy; D013274:Stomach Neoplasms / Q000150:complications / Q000556:secondary*; D013276:Stomach Ulcer / Q000209:etiology*
chemical_list: D007376:Interleukin-2