Metastatic renal cell carcinoma diagnosed by capsule endoscopy and double balloon endoscopy

Abstract

SummaryBackgroundRenal cell carcinoma commonly metastasizes to lung, liver, and bone. Small intestinal metastases are exceedingly rare.Case ReportA 75-year-old man presented at our hospital with tarry stools. He had undergone a right nephrectomy for renal cell carcinoma (RCC) 6 years previously; in addition, he had received antiplatelet treatment for ischemic heart disease. Esophagogastroduodenoscopy, total colonoscopy, and computed tomography did not identify any cause for the gastrointestinal bleeding. He underwent capsule endoscopy (CE), which revealed an ulcerated submucosal tumor in the jejunum. We performed a double-balloon endoscopy (DBE), and histological findings identified a clear cell carcinoma. We diagnosed metastasis from the RCC. We performed a jejunectomy to resect the tumor and thus eliminate the source of the bleeding.ConclusionsCE and DBE are useful diagnostic tools. We recommend investigating the possibility of small intestinal metastases in cases of intestinal bleeding or anemia in patients with a history of malignant tumor.

New detachable occlusion balloon unit for transrectal natural orifice translumenal endoscopic surgery

“…Previous animal and human studies of occlusion balloon devices have reported balloon placement times of 18 min or longer (11)(12)(13). In this study, the maximum time required for balloon placement was only 12 min.…”

“…Previous studies which used miniature endoscopes to place infiatable balloons in the bowel have demonstrated the safety of such procedures (11)(12)(13)(16)(17)(18)(19)(20).…”

Severe blood loss anaemia and recurrent intussusceptions as first presentation of bowel metastatic renal cell carcinoma: A case report and review of the literature

“…Using the combination of CE and DBE, it is possible to obtain clear endoscopic images of the lesions and histological diagnosis prior to the patient undergoing surgery. CE is a reliable approach to such screening, and DBE is an effective approach to the histological diagnosis of small intestinal neoplasms (16,17).…”

Clinical Spectrum of Patients with Renal Cell Carcinoma

“…They may behave as the leading point for an intestinal obstruction and intussusceptions. Periampullary region, duodenum and jejunum rank the most common sites .Yet, other sites as large bowel may be involved too (Eo et al, 2008;Loualidi et al, 2004;Nozawa et al, 2003;Papachristodoulou et al, 2004;Roviello et al, 2006;Sadler et al, 2007Takeda et al, 2011. The above cases highlight the importance of considering RCC metastasis as a source of intestinal bleeding and/or obstruction, especially in patients with a known cancer history.…”