A Case of Solitary Small Intestinal Metastasis from Renal Cell Carcinoma Diagnosed Preoperatively

Abstract

The patient, a 76-year-old man, had undergone laparoscopic left partial nephrectomy for renal cell carcinoma (RCC) 44 months earlier (the histopathological diagnosis was clear cell carcinoma, T1a, N0, M0), and was regularly followed-up at our department of urology. He had undergone retroperitoneal tumor resection for local recurrence of the RCC 15 months earlier. Abdominal CT at the present admission revealed an ileal mass. Lower gastro intestinal endoscopy revealed a type 1-like tumor at the terminal end of the ileum. Biopsy revealed features consistent with RCC. PET-CT showed abnormal uptake in the ileal mass and a mesenteric lymph node. We made the diagnosis of ileal metastasis from RCC and performed ileocecal resection and lymph node dissection. The patient has not exhibited disease recurrence until now, 6 months after the ileocecal resection. Small intestinal metastasis from RCC is often associated with multiple concomitant metastases. Isolated small intestinal metastasis from primary RCC in the absence of metastasis to the lung is rare, and only a few cases, including the present case, have been reported in Japan.