Gastric metastasis of renal cell carcinoma, presenting with melena

Abstract

A 70-year-old man with past medical history of left renal cell carcinoma status post nephrectomy in 1988 presented to our department, complaining of melena and anemia. He underwent partial gastrectomy for gastric metastasis in 2007, followed by pancreatectomy for pancreatic metastasis, by radiofrequency ablation for right renal metastasis (2009) , and by molecular target therapy for multiple liver metastasis and retroperitoneal metastasis (2012) . He also had an evidence of right adrenal metastasis in 2013. On gastrointestinal endoscopy, a protruding lesion covered with white moss was found on greater curvature of the upper part of gastric body (color 1, 2, 3) . The lesion showed bleeding diathesis during the procedure. The pathological findings of the lesion were consistent with the gastric metastasis of renal cell carcinoma. Although the patient’s initial symptoms, melena and anemia, were disappeared spontaneously after the biopsy, the patient decided to take palliative care including the deep sedation. Here, we report a case of gastric metastasis of renal cell carcinoma, which presented with gastrointestinal hemorrhage.