Rare Presentations of Metastatic Renal Cell Carcinoma with Hematochezia and Anemia
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2018, Vol 7, Issue 4
Abstract
Renal cell carcinoma (RCC) is the sixth most common cancer in men and the eighth most common cancer in women in the United States, with an estimated 65,150 new cases diagnosed in 2013 [1]. RCC’s classic presenting triad of hematuria, flank pain and palpable abdominal mass are only present in about 9 percent of patients and often, RCC is found incidentally on imaging. At diagnosis, about 16% of cases have evidence of disease in lymph nodes and 16% with distant metastases [2]. Typical sites for metastasis include lungs, bone, liver, and brain, [3] whereas intestinal metastasis is rare [4]. It is important for gastroenterologists to acknowledge the possibility of presence of metastases during endoscopy in these patients. In this case series, we present three patients with history of renal cell carcinoma with gastrointestinal metastases.A 52-year-old male with HIV and new onset iron deficiency anemia presented for further evaluation of acute blood loss anemia with hemoglobin decrease from 16 to 7.9mg/dl. Six months prior to presentation, he had EGD with LA Class B esophagitis and colonoscopy with 2 mm sigmoid polyp (biopsy with tubular adenoma). Video Capsule endoscopy showed an ulcerated lesion in distal ileum with active oozing (Figure 1A) and a non-bleeding arteriovenous malformation (Figure1B). A 1.5cm ulcerated distal ileum lesion was discovered on single balloon enteroscopy subsequently with biopsy revealing metastatic carcinoma with clear cell phenotype, with immunohistochemistry consistent with primary renal cell carcinoma. A new diagnosis of metastatic RCC was made by single balloon enteroscopy
Authors and Affiliations
Janki Patel, Niraj Patel, Denise Kalmaz
Keywords
Related Articles
- EP ID EP588504
- DOI 10.26717/BJSTR.2018.07.001529
- Views 145
- Downloads 0
An Alternative Therapy with Ozone to Avoid Antimicrobial Resistence (AMR) in Uterine Infections in Dairy Cattle
Antimicrobial resistance (AMR) is major problem in treatment of uterine infections in dairy animals. To suggest an alternative treatment, avoiding antibiotics, the effect of ozone as therapy against common bacterial uter...
Bio sorption Studies of Chromium Ions with Modified Chicken Feathers
Modified chicken feather has been used as biosorbent for removing chromium ions from aqueous solution. The adsorption capacity tests were performed on an equilibrium batch basis. The parameters such as contact time, bios...
Improving Quality of Life among Stroke Patients with Dysphagia: A Case Report
Dysphagia is a disorder that includes any dysfunction from chewing in the mouth to the passage of the bolus into the oesophagus [1]. In the United States, 50%-75% of nursing home residents are estimated as having dysphag...
Hexadactyly: A Rare Case
A 2-year-old Caucasian female patient, referred to our Department, presented on physical examination a symmetrical duplication of the 5th finger in both hands and feet. (Figure 1) Bone structures could be also palpated a...
Modern Treatment Approaches for Osteoporotic Low -Traumatic Vertebral Body Fractures
Osteoporosis is the global burden public health issue due to the high prevalence and substantial impact on morbidity and mortality; the incidence rates of osteoporotic fracturesare rise exponentially with an aging popula...