title: Renal cell carcinoma presenting with Melena from direct invasion into the duodenum: a case report and a review of literature.
abstract: Today the classic triad of flank pain, hematuria and a palpable abdominal mass is rarely present at initial diagnosis of renal cell carcinoma due to the growing number of cases diagnosed incidentally on imaging studies. We report a case of a 58-year-old female who presented with melena where a subsequent esophagogastroduodenoscopy demonstrated a bleeding duodenal lesion. Pathologic study of a biopsy revealed Clear Cell RCC and an ensuing abdominal CT revealed the direct duodenal invasion of a primary renal mass. We also provide a brief review of nephrectomy in the face of metastatic renal cell carcinoma.
authors.forename: Ryan
authors.initials: R
authors.lastname: Street
authors.forename: Jordan
authors.initials: J
authors.lastname: Brady
authors.forename: Gennady
authors.initials: G
authors.lastname: Slobodav
mesh_terms: D001706:Biopsy; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D004386:Duodenum / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D008551:Melena / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000000981:diagnostic imaging / Q000473:pathology; D009392:Nephrectomy / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods