Document Type : Case Report(s)

Authors

• Bita Geramizadeh ¹
• AmirAhmad Mostaghni ²
• Zeinab Ranjbar ³
• Farid Moradian ⁴
• Mina Heidari ³
• Mohammad Bagher Khosravi ⁵
• Seyed Ali Malekhosseini ⁴

¹ Shiraz Transplant Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran; Department of Pathology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

² Department of Internal Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

³ Department of Pathology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

⁴ Department of Surgery, Shahid Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran

⁵ Department of Anesthesiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

Abstract

Renal cell carcinoma comprises about 2% of adult tumors. The overall 10-year survival rate of patients with RCC after nephrectomy is about 18-27%. The incidence of metastasis of initial RCC is about 24-28%, but this rate after nephrectomy is as high as 51%. The most common site of recurrence is the lung, however liver and bone metastases are common.There are many reported cases with late metastasis, however isolated late metastasis in the gastrointestinal tract especially duodenum is very rare.Herein we report our experience with a case of gastrointestinal bleeding secondary to metastatic renal cell carcinoma to duodenum, 16 years after nephrectomy.To the best of our knowledge, about 30 of such cases have been reported in the English literature. Many of the previous cases have been part of disseminated disease and isolated duodenal metastasis is very rare. The longest reported duration between nephrectomy for renal cell carcinoma and duodenal metastasis has been 13 years, thus it seems our case to be also unique because of very late duodenal metastasis.

Keywords

• Duodenal ulcer
• Gastrointestinal hemorrhage
• Renal cell carcinoma
• Pancreaticoduodenectomy