title: An unusual case of metastatatic renal cell carcinoma presenting as melena and duodenal ulcer, 16 years after nephrectomy; a case report and review of the literature.
abstract: Renal cell carcinoma comprises about 2% of adult tumors. The overall 10-year survival rate of patients with RCC after nephrectomy is about 18-27%. The incidence of metastasis of initial RCC is about 24-28%, but this rate after nephrectomy is as high as 51%. The most common site of recurrence is the lung, however liver and bone metastases are common. There are many reported cases with late metastasis, however isolated late metastasis in the gastrointestinal tract especially duodenum is very rare. Herein we report our experience with a case of gastrointestinal bleeding secondary to metastatic renal cell carcinoma to duodenum, 16 years after nephrectomy. To the best of our knowledge, about 30 of such cases have been reported in the English literature. Many of the previous cases have been part of disseminated disease and isolated duodenal metastasis is very rare. The longest reported duration between nephrectomy for renal cell carcinoma and duodenal metastasis has been 13 years, thus it seems our case to be also unique because of very late duodenal metastasis.
authors.affiliation: Shiraz Transplant Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran; ; Department of Pathology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran;
authors.forename: Bita
authors.initials: B
authors.lastname: Geramizadeh
authors.affiliation: Department of Internal Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran;
authors.forename: AmirAhmad
authors.initials: A
authors.lastname: Mostaghni
authors.affiliation: Department of Pathology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran;
authors.forename: Zeinab
authors.initials: Z
authors.lastname: Ranjbar
authors.affiliation: Department of Surgery, Shahid Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran;
authors.forename: Farid
authors.initials: F
authors.lastname: Moradian
authors.affiliation: Department of Pathology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran;
authors.forename: Mina
authors.initials: M
authors.lastname: Heidari
authors.affiliation: Department of Anesthesiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Mohammad Bagher
authors.initials: MB
authors.lastname: Khosravi
authors.affiliation: Department of Surgery, Shahid Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran;
authors.forename: Seyed Ali
authors.initials: SA
authors.lastname: Malekhosseini
keywords: Duodenal ulcer; Gastrointestinal hemorrhage; Pancreaticoduodenectomy; Renal cell carcinoma
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