A case of metastasis of renal cell carcinoma to the small intestine detected preoperatively by capsule endoscopy and double balloon enteroscopy

Abstract

We report a case of renal cell carcinoma (RCC) metastasis to the small intestine that was diagnosed preoperatively. A 68-year-old man who underwent right renal resection for RCC at age 58 was referred to our hospital with persistent melena. The focus of bleeding was not identified on upper gastrointestinal endoscopy or colonoscopy. Therefore, the small intestine was examined. The elevated mass was seen on capsule endoscopy. Double balloon enteroscopy revealed an ulcerative tumor in the ileum about 180 cm from the ileocecal valve. An endoscopic forceps biopsy specimen showed metastasis of RCC to the small intestine. The small intestine was partially excised. The histopathological diagnosis was metastasis of RCC. After 7 months, the small intestine was partially excised again for RCC recurrence to the small intestine. Metastasis of RCC to the small intestine is rare and difficult to diagnosis before surgery. However, early detection of RCC metastasis contributes to prognosis and QOL. Capsule endoscopy and double balloon enteroscopy should be used for patients suffering from past RCC.