Jejunal Metastasis from Clear Cell Renal Cell Carcinoma

Volume 3 - Issue 5

Juan Pablo Montemayor-Lozano¹, Karla Ivonne Chávez-Blanco¹, Rodolfo Morales-Avalos², Matías Salinas-Chapa² and Guillermo Elizondo-Riojas¹

Received: November 29, 2019   Published: December 05, 2019

DOI: 10.32474/SCSOAJ.2019.03.000174

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Abstract

Introduction: To present a case of a jejunal metastasis from a clear cell renal cell carcinoma (RCC) in an old-aged woman, with a history of radical left nephrectomy 20 years before the actual diagnosis.

Case report: 78 years old female presented to the emergency department, with a 7-day history of melena, diffuse abdominal complains and hyporexia. The only relevant history was a left radical nephrectomy because a RCC, which was treated only with surgery. After the medical evaluation and a normal upper gastrointestinal endoscopy an abdominal angiotomography was requested, demonstrating a bowel intussusception at the jejunum caused by an hypervascular mass, suspecting a metastasis from the RCC. The patient undergone a small bowel resection of the affected jejunum, with primary anastomosis, the histologic diagnosis of jejunal metastasis of clear cell RCC was made. After that the patient went on chemotherapy, finishing all the cycles without major complications. Actually the patient is on oncologic surveillance and refers clinically asymptomatic.

Conclusión: RCC accounts for 3% of the total of adult malignancies, the most common subtype is the clear cell carcinoma. The prevalence of metastasis in patients with RCC is approximately 33%, but less than 2% of this correspond to small intestine metastasis. Strict follow up is recommended because the recurrence of metastatic RCC is 11% after 10 years of the initial diagnosis. The radiological characteristics of the primary clear cell RCC depends on the modality of imaging used, but it will commonly demonstrate as a hypervascular exophytic mass. The metastatic lesions from the RCC tend to be similar of the primary tumor (hypervascular mass), when they appear on bone they show as lytic lesions. For the relapse of the clear cell RCC the treatment will from sole medical treatment to metastasectomy plus medical treatment.

Keywords: Kidney; carcinoma; metastasis; small intestine; clear cells

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