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Case ReportCASE REPORTS AND CLINICAL OBSERVATIONS

Metastatic Renal Cell Carcinoma Presenting as a Bleeding Gastric Polyp

Muhammad F. Mubarak, Ebubekir S. Daglilar, Thom Smilari and Arnab Ray
Ochsner Journal September 2018, 18 (3) 274-276; DOI: https://doi.org/10.31486/toj.17.0086
Muhammad F. Mubarak
1Department of Internal Medicine, Ochsner Clinic Foundation, ,
2Department of Internal Medicine, King Saud University, College of Medicine, , Saudi Arabia
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Ebubekir S. Daglilar
3Department of Gastroenterology and Hepatology, Ochsner Clinic Foundation, ,
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Thom Smilari
4Department of Pathology, Ochsner Clinic Foundation, ,
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Arnab Ray
3Department of Gastroenterology and Hepatology, Ochsner Clinic Foundation, ,
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  • For correspondence: array@ochsner.org
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Abstract

Background: Renal cell carcinoma (RCC) is responsible for nearly 13,000 deaths in the United States every year, predominantly because of metastasis to other bodily organs. However, metastasis of RCC to the stomach occurs rarely; it presents as solitary or multiple polyps or as ulcers concerning for primary gastric carcinoma. Bleeding from metastasis to the stomach is a rare and underrecognized cause of gastrointestinal bleeding. We describe a case of gastrointestinal bleeding in an elderly female who was found to have a gastric polyp of RCC origin.

Case Report: An 83-year-old female presented to our hospital for evaluation of an acute right basal ganglia hemorrhage after falling at her nursing home. Her hospital course was notable for melenic stool and anemia. Upper endoscopy revealed a single 40-mm pedunculated polyp and active bleeding on the lesser curvature of the stomach. Polypectomy and clipping were performed. Pathology was consistent with metastatic clear cell RCC. The patient's family declined a referral to oncology for evaluation of the newly diagnosed malignancy and opted for hospice care.

Conclusion: This case illustrates the potential for metastatic RCC to involve the stomach and cause gastrointestinal bleeding and anemia. The case also illustrates the role of upper gastrointestinal endoscopy in diagnosing and treating metastatic causes of gastrointestinal bleeding.

Keywords:
  • Gastrointestinal hemorrhage
  • gastrointestinal neoplasms
  • intestinal polyps
  • neoplasm metastasis
  • renal cell carcinoma
  • © Academic Division of Ochsner Clinic Foundation
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Ochsner Journal: 18 (3)
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Vol. 18, Issue 3
Sep 2018
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Metastatic Renal Cell Carcinoma Presenting as a Bleeding Gastric Polyp
Muhammad F. Mubarak, Ebubekir S. Daglilar, Thom Smilari, Arnab Ray
Ochsner Journal Sep 2018, 18 (3) 274-276; DOI: 10.31486/toj.17.0086

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Metastatic Renal Cell Carcinoma Presenting as a Bleeding Gastric Polyp
Muhammad F. Mubarak, Ebubekir S. Daglilar, Thom Smilari, Arnab Ray
Ochsner Journal Sep 2018, 18 (3) 274-276; DOI: 10.31486/toj.17.0086
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Keywords

  • gastrointestinal hemorrhage
  • gastrointestinal neoplasms
  • intestinal polyps
  • neoplasm metastasis
  • renal cell carcinoma

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