Gastrointestinal Involvement of Recurrent Renal Cell Carcinoma: CT Findings and Clinicopathologic Features

Abstract

ObjectiveTo retrospectively evaluate the CT findings and clinicopathologic features in patients with gastrointestinal (GI) involvement of recurrent renal cell carcinoma (RCC).Materials and MethodsThe medical records were reviewed for 15 patients with 19 pathologically proven GI tract metastases of RCC. The CT findings were analyzed to determine the involved sites and type of involvement; lesion size, morphology, and contrast enhancement pattern; and occurrence of lymphadenopathy, ascites and other complications.ResultsThe most common presentation was GI bleeding (66.7%). The average interval between nephrectomy and the detection of GI involvement was 30.4 ± 37.4 months. GI lesions were most commonly found in the ileum (36.8%) and duodenum (31.6%). A distant metastasis (80%) was more common than a direct invasion from metastatic lesions. The mean lesion size was 34.1 ± 15.0 mm. Intraluminal polypoid masses (63.2%) with hyperenhancement (78.9%) and heterogeneous enhancement (63.2%) were the most common findings. No patients had regional lymphadenopathy. Complications occurred in four patients, with one each of bowel obstruction, intussusception, bile duct dilatation, and pancreatic duct dilatation.ConclusionGI involvement of recurrent RCC could be included in the differential diagnosis of patients with heterogeneous, hyperenhanced intraluminal polypoid masses in the small bowel on CT scans along with a relative paucity of lymphadenopathy.

Age of Data in Contemporary Research Articles Published in Representative General Radiology Journals

“…In total, 50 KJR (9101112131415161718192021222324252627282930313233343536373839404142434445464748495051525354565758), 492 ER, and 254 Radiology articles reported original research studies analyzing patient data. Of these, 44 (88%; 95% CI: 75.8–94.8%) (910121314151617181920212324262728293031323435363738394041424344474849505152535455565758), 359 (73%; 95% CI: 68.9–76.7%), and 211 (83.1%; 95% CI: 78–87.2%) articles, respectively, revealed the start and end of data collection to the level of calendar month.…”

“…Of these, 44 (88%; 95% CI: 75.8–94.8%) (910121314151617181920212324262728293031323435363738394041424344474849505152535455565758), 359 (73%; 95% CI: 68.9–76.7%), and 211 (83.1%; 95% CI: 78–87.2%) articles, respectively, revealed the start and end of data collection to the level of calendar month. The point estimate value of this proportion was slightly larger in KJR than in ER and Radiology, although the difference was not statistically significant.…”

Secondary involvement of the gastrointestinal tract by renal cell carcinoma

“…The differential diagnosis of a GI tumor includes GI stromal tumors, neuroendocrine tumors, lymphoma, and melanoma. 8 Classically, RCC and PAX8 staining would suggest renal origin, because these markers have been previously shown to stain 98% and 72% to 85% of clear cell renal cell carcinomas, respectively. 9 However, PAX8 can be positive in other tumor types such as carcinoma of Mullerian origin.…”

Metastatic renal cell carcinoma to the small bowel: three cases of GI bleeding and a literature review

“…The actual prevalence of metastatic RCC to the small bowel is largely unknown. One cohort study of 3,637 patients with RCC identified 26 patients (0.71%) with pathologically proven RCC metastases to the GI tract [15]. However, this number only represents symptomatic cases that came to medical attention and had tissue confirmation and thus likely underestimates the true prevalence of disease.…”