Gastric metastasis from renal cell carcinoma with gastrointestinal bleeding: a case report and review of the literature.
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.
Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan.
Katsunobu
K
Sakurai
Kazuya
K
Muguruma
Sadaaki
S
Yamazoe
Kenjiro
K
Kimura
Takahiro
T
Toyokawa
Ryosuke
R
Amano
Naoshi
N
Kubo
Hiroaki
H
Tanaka
Masakazu
M
Yashiro
Masaichi
M
Ohira
Kosei
K
Hirakawa
D002292:Carcinoma, Renal Cell / Q000150:complications / Q000175:diagnosis / Q000556:secondary*; D017809:Fatal Outcome; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000150:complications / Q000175:diagnosis / Q000556:secondary*