title: Metastatic renal cell carcinoma diagnosed by capsule endoscopy and double balloon endoscopy.
abstract: BACKGROUND
  Renal cell carcinoma commonly metastasizes to lung, liver, and bone. Small intestinal metastases are exceedingly rare.
  
  
  METHODS
  A 75-year-old man presented at our hospital with tarry stools. He had undergone a right nephrectomy for renal cell carcinoma (RCC) 6 years previously; in addition, he had received antiplatelet treatment for ischemic heart disease. Esophagogastroduodenoscopy, total colonoscopy, and computed tomography did not identify any cause for the gastrointestinal bleeding. He underwent capsule endoscopy (CE), which revealed an ulcerated submucosal tumor in the jejunum. We performed a double-balloon endoscopy (DBE), and histological findings identified a clear cell carcinoma. We diagnosed metastasis from the RCC. We performed a jejunectomy to resect the tumor and thus eliminate the source of the bleeding.
  
  
  CONCLUSIONS
  CE and DBE are useful diagnostic tools. We recommend investigating the possibility of small intestinal metastases in cases of intestinal bleeding or anemia in patients with a history of malignant tumor.
authors.affiliation: Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Takeda
authors.forename: Tomoyoshi
authors.initials: T
authors.lastname: Shibuya
authors.forename: Taro
authors.initials: T
authors.lastname: Osada
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Izumi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Mitomi
authors.forename: Osamu
authors.initials: O
authors.lastname: Nomura
authors.forename: Sueto
authors.initials: S
authors.lastname: Suzuki
authors.forename: Hiroki
authors.initials: H
authors.lastname: Mori
authors.forename: Kenshi
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Kon
authors.forename: Wataru
authors.initials: W
authors.lastname: Abe
authors.forename: Kazuko
authors.initials: K
authors.lastname: Beppu
authors.forename: Naoko
authors.initials: N
authors.lastname: Sakamoto
authors.forename: Akihito
authors.initials: A
authors.lastname: Nagahara
authors.forename: Michiro
authors.initials: M
authors.lastname: Otaka
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Ogihara
authors.forename: Takashi
authors.initials: T
authors.lastname: Yao
authors.forename: Sumio
authors.initials: S
authors.lastname: Watanabe
mesh_terms: D000368:Aged; D053704:Capsule Endoscopy / Q000379:methods*; D002292:Carcinoma, Renal Cell / Q000473:pathology*; D058582:Double-Balloon Enteroscopy / Q000379:methods*; D006801:Humans; D007414:Intestinal Neoplasms / Q000175:diagnosis* / Q000556:secondary*; D007680:Kidney Neoplasms / Q000473:pathology*; D008297:Male; D009362:Neoplasm Metastasis