Metastatic Renal Cell Carcinoma to Duodenum and Pancreas 10 Years After Nephrectomy: A Case Report
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Abstract
Renal cell carcinoma (RCC) accounts for 2-3% of the malignant tumors in adult patients. The most common sites of metastasis are the lung, bone, liver and brain respectively. Unusual metastatic sites require attention during follow-up of renal cell carcinoma. The duodenum and pancreas are uncommon sites for metastasis from renal cell carcinoma. We describe here a 62-year-old man with metastastic renal cell carcinoma to the duodenum and pancreas. The patient presented with melena and bowel obstruction, 10 years after nephrectomy for renal cell carcinoma, then with initial diagnosis of ampula vater adenocarcinoma undergo an exploratory laparotomy and a mass was found in duodenum, vater ampulla and pancreas, then pancreaticoduodenectomy was performed. histopathological examination of mass showed a metastatic renal cell carcinoma with sarcomatoid component. In conclusion, patients after radical nephrectomy due to renal cell carcinoma require long-term systematic monitoring. Gastrointestinal metastasis from Renal cell carcinoma should be considered in nephrectomized patients with gastrointestinal symptoms.
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10. Pavlakis GM, Sakorafas GH, Anagnostopoulos GK. Intes- tinal metastases from renal cell carcinoma: a rare cause of intestinal obstruction and bleeding. The Mount Sinai journal of medicine, New York. 2004 Mar 1;71(2):127-30.
11. Abdul-Ghafar J, Din NU, Saadaat R, Ahmad Z. Meta- static renal cell carcinoma to pancreas and gastroin- testinal tract: a clinicopathological study of 3 cases and review of literature. BMC urology. 2021 Dec;21(1):1-8. https://doi.org/10.1186/s12894-021-00854-z
12. Park HJ, Kim HJ, Park SH, Lee JS, Kim AY, Ha HK. Gastrointestinal involvement of recurrent renal cell car- cinoma: CT findings and clinicopathologic features. Korean journal of radiology. 2017 May;18(3):452. https://doi.org/10.3348/kjr.2017.18.3.452
13. Pavlakis GM, Sakorafas GH, Anagnostopoulos GK. Intes- tinal metastases from renal cell carcinoma: a rare cause of intestinal obstruction and bleeding. The Mount Sinai journal of medicine, New York. 2004 Mar 1;71(2):127-30.
14. McNichols DW, Segura JW, DeWeerd JH. Renal cell carcinoma: long-term survival and late recurrence. The Journal of urology. 1981 Jul 1;126(1):17-23 https://doi.org/10.1016/S0022-5347(17)54359-1
15. Shah IA, Haddad FS, Wheeler L, Chinichian A. Metastatic Renal Cell Carcinoma: Late Recurrence and Prolonged Survival. Journal of Urologic Pathology. 1996;4:289-98.
16. Piskorz Ł, Mitura K, Olejniczak W, Misiak P, Jablon- ski S. Atypical locations of renal cell carcino- ma metastases to the pancreas and duodenum. Research and Reports in Urology. 2021;13:17. https://doi.org/10.2147/RRU.S290150
17. Geramizadeh B, Mostaghni A, Ranjbar Z, Moradian F, Heidari M, Khosravi MB, Malekhosseini SA. 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. Iranian journal of medical sciences. 2015 Mar;40(2):175.
18. Omranipour R, Zadeh HM, Ensani F, Yadegari S, Miri SR. Duodenal metastases from renal cell carci- noma presented with melena: review and case re- port. Iranian journal of pathology. 2017;12(3):272. https://doi.org/10.30699/ijp.2017.25687
19. Radley MG, McDonald JV, Pilcher WH, Wilbur DC. Late sol- itary cerebral metastases from renal cell carcinoma: report of two cases. Surgical neurology. 1993 Mar 1;39(3):230-4. https://doi.org/10.1016/0090-3019(93)90189-8
2. Moch H, Cubilla AL, Humphrey PA, Reuter VE, Ulbright TM. The 2016 WHO classification of tumours of the urinary sys- tem and male genital organs-part A: renal, penile, and testic- ular tumours. European urology. 2016 Jul 1;70(1):93-105. https://doi.org/10.1016/j.eururo.2016.02.029
3. Gorski RL, Jalil SA, Razick M. An obscure cause of gastrointestinal bleeding: renal cell carcinoma metastasis to the small bowel. International jour- nal of surgery case reports. 2015 Jan 1;15:130-2. https://doi.org/10.1016/j.ijscr.2015.08.011
4. Zhao H, Han K, Li J, Liang P, Zuo G, Zhang Y, Li H. A case of wedge resection of duodenum for massive gastrointestinal bleeding due to duodenal metastasis by renal cell carcino- ma. World journal of surgical oncology. 2012 Dec;10(1):1-5. https://doi.org/10.1186/1477-7819-10-199
5. Senadhi V, Jani N, Erlich R. Metastatic renal cell cancer and a gastric mass: an unusual finding. Case reports in gastroenterology. 2010;4(3):421-8. https://doi.org/10.1159/000320871
6. Gooran S, Yasseri AF, Behtash N, Khalili M, Asadi M. Mandibular mass as an only presentation of metatatic re- nal cell carcinoma for four years: a case report. Urology Journal. 2017 Jan 18;14(1):2979-81.
7. Eo WK, Kim GY, Choi SI. A case of multiple intussuscep- tions in the small intestine caused by metastatic renal cell carcinoma. Cancer research and treatment: official journal of Korean Cancer Association. 2008 Jun;40(2):97. https://doi.org/10.4143/crt.2008.40.2.97
8. Bhatia A, Das A, Kumar Y, Kochhar R. Renal cell carcinoma metastasizing to duodenum: a rare oc-currence. Diagnostic Pathology. 2006 Dec;1(1):1-4. https://doi.org/10.1186/1746-1596-1-29
9. Lynch-Nyhan A, Fishman EK, Kadir S. Diagnosis and management of massive gastrointestinal bleeding ow- ing to duodenal metastasis from renal cell carcino- ma. The Journal of urology. 1987 Sep;138(3):611-3. https://doi.org/10.1016/S0022-5347(17)43275-7
10. Pavlakis GM, Sakorafas GH, Anagnostopoulos GK. Intes- tinal metastases from renal cell carcinoma: a rare cause of intestinal obstruction and bleeding. The Mount Sinai journal of medicine, New York. 2004 Mar 1;71(2):127-30.
11. Abdul-Ghafar J, Din NU, Saadaat R, Ahmad Z. Meta- static renal cell carcinoma to pancreas and gastroin- testinal tract: a clinicopathological study of 3 cases and review of literature. BMC urology. 2021 Dec;21(1):1-8. https://doi.org/10.1186/s12894-021-00854-z
12. Park HJ, Kim HJ, Park SH, Lee JS, Kim AY, Ha HK. Gastrointestinal involvement of recurrent renal cell car- cinoma: CT findings and clinicopathologic features. Korean journal of radiology. 2017 May;18(3):452. https://doi.org/10.3348/kjr.2017.18.3.452
13. Pavlakis GM, Sakorafas GH, Anagnostopoulos GK. Intes- tinal metastases from renal cell carcinoma: a rare cause of intestinal obstruction and bleeding. The Mount Sinai journal of medicine, New York. 2004 Mar 1;71(2):127-30.
14. McNichols DW, Segura JW, DeWeerd JH. Renal cell carcinoma: long-term survival and late recurrence. The Journal of urology. 1981 Jul 1;126(1):17-23 https://doi.org/10.1016/S0022-5347(17)54359-1
15. Shah IA, Haddad FS, Wheeler L, Chinichian A. Metastatic Renal Cell Carcinoma: Late Recurrence and Prolonged Survival. Journal of Urologic Pathology. 1996;4:289-98.
16. Piskorz Ł, Mitura K, Olejniczak W, Misiak P, Jablon- ski S. Atypical locations of renal cell carcino- ma metastases to the pancreas and duodenum. Research and Reports in Urology. 2021;13:17. https://doi.org/10.2147/RRU.S290150
17. Geramizadeh B, Mostaghni A, Ranjbar Z, Moradian F, Heidari M, Khosravi MB, Malekhosseini SA. 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. Iranian journal of medical sciences. 2015 Mar;40(2):175.
18. Omranipour R, Zadeh HM, Ensani F, Yadegari S, Miri SR. Duodenal metastases from renal cell carci- noma presented with melena: review and case re- port. Iranian journal of pathology. 2017;12(3):272. https://doi.org/10.30699/ijp.2017.25687
19. Radley MG, McDonald JV, Pilcher WH, Wilbur DC. Late sol- itary cerebral metastases from renal cell carcinoma: report of two cases. Surgical neurology. 1993 Mar 1;39(3):230-4. https://doi.org/10.1016/0090-3019(93)90189-8
| Files | ||
| Issue | Vol 7 No 4 (2022): July-August | |
| Section | Case Report(s) | |
| DOI | https://doi.org/10.18502/crcp.v7i4.11598 | |
| Keywords | ||
| Renal cell carcinoma Metastases Duodenum Surgery Case report | ||
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How to Cite
1.
Akbari Oryani M, Zare A, Soltani Sabi M, Mashhadi-Rajabi MT. Metastatic Renal Cell Carcinoma to Duodenum and Pancreas 10 Years After Nephrectomy: A Case Report. CRCP. 2023;7(4):199-203.
