Solitary Colon Metastasis from Renal Cell Carcinoma

[摘要] Background: The most common renal malignancy in adults is renal cell carcinoma (RCC). Metastatic disease is relatively common and at the time of diagnosis may be present in upto 25% of patients. Frequent sites of metastasis are lung, bone, brain, liver and adrenal glands. The risk of recurrence even after curative resection is a 30-40%. The gastrointestinal tract, particularly the colon, represents a very uncommon site of late metastatic disease. Case Report: We present a case of a 40-year-old-male with solitary colonic renal cell carcinoma metastasis. Patient underwent laparoscopic nephrectomy in 2016 in view of renal mass and was followed by chemotherapy for clear cell carcinoma. He had history of water diarrhoea, abdominal pain, tenesmus and haematochezia. Investigation revealed circumferential thickening involving the proximal and mid segment of sigmoid colon, stricture around 30 cm from the anal verge and histopathology suggestive of deposits of renal cell carcinoma. FDG PET scan was suggestive of enhancing necrotic lesion in the wall of sigmoid colon with multiple deposits noted in adjacent mesentery. On diagnostic laparoscopy focal lesion was noted in the sigmoid colon with no evidence of omental, peritoneal and any other metastasis. Resection and anastomosis of lesion was done. Histopathology was clear cell carcinoma with clear margins. Conclusion: The colon is a potential, though uncommon, site for solitary metastasis from RCC. Oncologic resection with negative margins may result in long-term survival in patients with isolated metastatic disease.

[学科分类] 生理学

[关键词] Colonic Diseases;Metastasis;Renal Cell Carcinoma;Sigmoid Colon;Solitary Kidney.