Duodenal Bleeding from Metastatic Renal Cell Carcinoma

Rustagi, Tarun; Rangasamy, Priya; Versland, Mark

doi:10.1159/000327996

Cited by 31 publications

(47 citation statements)

References 24 publications

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“…A majority of duodenal metastases, around 70%, occur from the right kidney due to the greater risk of regional invasion, as the patients we present (3, 6, 15). …”

Section: Discussionmentioning

confidence: 52%

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Surgical Excision of Duodenal/Pancreatic Metastatic Renal Cell Carcinoma

Espinoza¹,

Hassani²,

Vaishampayan³

et al. 2014

Front. Oncol.

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Renal cell carcinoma (RCC) has a potential to metastasize to almost any site and this may occur many years following nephrectomy. We present six cases with uncommon sites of metastasis: four patients presented with distal pancreatic metastasis and two with duodenal/head of the pancreas metastasis. Time to metastatic disease varied from 1 to 19 years following renal surgery. For patients are alive and two succumbed to their disease. Long-term survival can be achieved with aggressive surgical excision of disease.

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“…A majority of duodenal metastases, around 70%, occur from the right kidney due to the greater risk of regional invasion, as the patients we present (3, 6, 15). …”

Section: Discussionmentioning

confidence: 52%

“…RCC metastases represent 7.1% of these lesions and are most frequently located in the periampullary region or the duodenal bulb (3, 4, 10). Metastatic lesions to the pancreas are uncommon, accounting for only 5% of all pancreatic malignancies (7).…”

Section: Discussionmentioning

confidence: 99%

Surgical Excision of Duodenal/Pancreatic Metastatic Renal Cell Carcinoma

Espinoza¹,

Hassani²,

Vaishampayan³

et al. 2014

Front. Oncol.

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“…Sixty-nine percent of patients with solitary GI metastasis from RCC present with GIB, but massive GIB is a rare occurrence (Ohmura et al, 2000). An ulcerative metastatic mass in the duodenum is the main cause of GIB (Rustagi et al, 2011;Chang et al, 2004;Cherian et al, 2011). Duodenal involvement with pseudoaneurysm formation as the cause of GI bleeding has also been reported in patients with clinical history of RCC in the literature (Blake et al, 1995).…”

Section: Resultsmentioning

confidence: 99%

Local recurrence of renal cell carcinoma presented with massive gastrointestinal bleeding: management with renal artery embolization

et al. 2019

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Background: Gastrointestinal bleeding from renal cell carcinoma metastasis is an uncommon manifestation of tumor recurrence and is usually difficult to control. Palliative trans-catheter embolization to control the bleeding has been used and described in the literature. Case presentation: The present report describes a 62-years-old male with local recurrence of RCC who presented with upper GI bleeding as the primary manifestation 10 years after right-sided partial nephrectomy. A pseudoaneurysm of renal artery with erosion into the duodenal lumen was responsible for the massive bleeding and was controlled with coil embolization. Conclusion: This case report highlights the importance of high index suspicion in post-nephrectomy patients for RCC, presenting with new symptoms. Aggressive gastrointestinal workup and adequate awareness of available minimallyinvasive endovascular options for controlling GIB in these patients, are of paramount importance.

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“…Generally, an immune cell-inhibiting mechanism is present in the microcirculatory environment of tumors (20). A trace number of cancer cells of RCC were latently present under the control of the immunological surveillance mechanism, but it may have manifested because the DLBCL tumor volume rapidly increased and inhibited immunity, and the subsequent growth of metastatic cancer cells from RCC may have been slightly rapid, unlike the slow growth previously reported (1,6,17).…”

Section: Discussionmentioning

confidence: 96%

“…According to the review of Rustagi et al (17), the mean duration post nephrectomy to diagnosis of solitary duodenal metastases was 7.9±4.7 years (median 8 years). RCC can metastasize for a long period of disease latency after nephrectomy, via the lymphatic or hematogenous route, as well as by peritoneal dissemination or direct invasion into adjacent anatomic structures (18).…”

Section: Discussionmentioning

confidence: 99%

Late duodenal metastasis from renal cell carcinoma with newly developed malignant lymphoma: A case report

Saito¹,

Senjo²,

Kanaya³

et al. 2018

mol clin onc

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Abstract. Duodenal metastasis from renal cell carcinoma (RCC) is rare. The current case report presents a very rare case of late duodenal metastasis from RCC with newly developed malignant lymphoma (diffuse large B-cell lymphoma: DLBCL) at the same time. A 64-year-old man with systemic lymph nodes swelling who had undergone left nephrectomy for RCC 25 years previously, was admitted to the present hospital. Inguinal lymph node biopsy was performed, leading to a diagnosis of DLBCL. fluorine-18-fluorodeoxy-glucose ( 18 F-FDG)-positron emission tomography (PET)/computed tomography (CT) revealed multiple lymph nodes, spleen, and ileocecal lesions. CT revealed an obvious hypervascular tumor involving the duodenum/pancreatic head. The tumor was false-negative on 18 F-FDG-PET/CT. On esophagogastroduodenoscopy, the tumor was detected in the descending portion of the duodenum and was observed to be consistent with the submucosal tumor with a central ulcer, resembling those of ulcer-forming DLBCL. A biopsy was then performed carefully, and a clear cell RCC-derived metastatic cancer was diagnosed. Ileocolonoscopy revealed mucosal thickening of the terminal ileum, and led to a diagnosis of DLBCL infiltration with biopsy. To the best of the author's knowledge, this is the first case report of the coexistence of metastatic cancer from RCC and malignant lymphoma in the small intestine simultaneously. It was necessary to make a careful differential diagnosis in the imaging studies.

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Duodenal Bleeding from Metastatic Renal Cell Carcinoma

Cited by 31 publications

References 24 publications

Surgical Excision of Duodenal/Pancreatic Metastatic Renal Cell Carcinoma

Surgical Excision of Duodenal/Pancreatic Metastatic Renal Cell Carcinoma

Local recurrence of renal cell carcinoma presented with massive gastrointestinal bleeding: management with renal artery embolization

Late duodenal metastasis from renal cell carcinoma with newly developed malignant lymphoma: A case report

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