Journal article
Not Your Usual Suspect: Clear Cell Renal Cell Carcinoma Presenting as Ulcerative Esophagitis
Curēus (Palo Alto, CA), Vol.10(6), p.e2821
06/18/2018
DOI: 10.7759/cureus.2821
PMCID: PMC6101459
PMID: 30131915
Abstract
Renal cell carcinoma (RCC) has the propensity to hematogenously metastasize to the lung, bone, or liver, however, metastasis to the esophagus is exceedingly rare. We report a case of ulcerative esophagitis secondary to recurrent metastatic renal cell cancer status post remote nephrectomy. An 82-year-old Caucasian male presented with dark tarry stools for two days, progressive dysphagia to solid food for several weeks and unintentional weight loss. His past medical history was significant for hypertension, diverticulosis and right-sided renal cell cancer for which he underwent nephrectomy 13 years ago. Physical examination was unremarkable. Laboratory data showed hemoglobin of 12.5 g/dL, with normal platelet count and an international normalized ratio (INR). His stools were positive for occult blood. Esophagogastroduodenoscopy (EGD) revealed a fragile mid esophageal mass and antral erosive gastritis which were both biopsied. Colonoscopy showed diverticulosis without stigmata of active gastrointestinal (GI) bleed. CT scan (computed tomography) of the chest showed a solid esophageal mass in the lower esophagus as well as a right upper lobe lung mass for which CT-guided needle biopsy was obtained. The histopathology revealed metastatic renal cell cancer of clear cell subtype. The patient was started on palliative radiotherapy. On completion of radiotherapy two months later, his dysphagia had resolved. The patient is currently on chemotherapy with Sunitinib. Metastatic involvement of esophagus is relatively uncommon and is reported in 6% of patients with metastatic lung, breast and prostate cancer. Esophageal metastasis of clear cell RCC is very rare and so far only seven cases have been reported. Diagnosis is confirmed by endoscopy, imaging and histopathology. Treatment options include surgical or endoscopic resection for a solitary metastatic lesion. If the tumor is unresectable, multidisciplinary treatment including radiation and chemotherapy is indicated.
Details
- Title: Subtitle
- Not Your Usual Suspect: Clear Cell Renal Cell Carcinoma Presenting as Ulcerative Esophagitis
- Creators
- Saeed Ali - Internal Medicine Residency, Florida Hospital, Orlando, USABasher Atiquzzaman - Gastroenterology, Florida Hospital Celebration Health, Celebration, USAKonrad Krall - Center for Interventional Endoscopy, Florida Hospital, Orlando, USARanjeet Kumar - Internal Medicine Residency, Florida Hospital, Orlando, USABo Liu - Diagnostic Radiology, Florida Hospital, Orlando, USAShantel Hebert-Magee - Pathology, Florida Hospital, Orlando , USA
- Resource Type
- Journal article
- Publication Details
- Curēus (Palo Alto, CA), Vol.10(6), p.e2821
- DOI
- 10.7759/cureus.2821
- PMID
- 30131915
- PMCID
- PMC6101459
- NLM abbreviation
- Cureus
- ISSN
- 2168-8184
- eISSN
- 2168-8184
- Language
- English
- Date published
- 06/18/2018
- Academic Unit
- General Internal Medicine; Internal Medicine
- Record Identifier
- 9984094568502771
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