Espinosa-González O, Ibarrola CJL, García-Cano E, Martínez-Reyes G, Oloarte-Merinos D

Language: Spanish
References: 10
Page: 207-210
PDF size: 189.33 Kb.

ABSTRACT

Introduction: Renal cancer (RC) may present metastasis in any organ, regardless of the time elapsed after nephrectomy. Upper gastrointestinal bleeding (UGB) secondary to oncological disease is rare, approximately 50% of cases cannot be resolved by surgery. Case report: 57-year-old male with history of left radical nephrectomy because of RC; he had radiation therapy and interpheron and was asymptomatic for nine years. He presents with weight loss and UGB. Endoscopy: ulcerated tumor in duodenum. Tomography: images suggestive of metastasis in lung and duodenum. Result: Histopathological report of metastatic renal cell carcinoma in the duodenum. Treatment with sunitinib is initiated without response; the outcome is fatal. Discussion: Renal tumors constitute 2-3% of tumors in adults. RC has an unpredictable metastatic pattern; its presentation in duodenum is exceptional, the most common clinical manifestation is UGB. Endoscopy is the diagnostic method of choice. The treatment of choice is surgical if the patient’s condition allows it. Otherwise, sunitinib, interferon-α and interleukin-2 have been used. Conclusion: In patients with UGB with history of RC, metastatic disease should be suspected regardless of the time elapsed since nephrectomy. Whenever possible, surgical treatment should be performed. The survival is short.

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