Rare occurrence of small bowel intussusception due to synchronous metastasis of renal cell carcinoma.

BACKGROUND

Renal carcinoma is the third most common urological cancer, with 30% of patients presenting with metastases at diagnosis. Metastases to the small intestine are rare (0.7-1.1%), and their presentation as intestinal intussusception is even more uncommon, with only a few cases reported in the literature.

AIMS: The aim of the study was to present a case of stage IV clear cell renal carcinoma with a rare presentation of intestinal intussusception, leading to emergency department admission due to severe anemia and melena.

METHODS

A 62-year-old man presented with melena for 2 months and a critically low hemoglobin level of 2.9 g/dL (normal range: 13.5-17.5 g/dL). Abdominal and pelvic angiotomography identified an exophytic lesion in the left kidney consistent with renal carcinoma and an approximately 16 cm ileal intussusception.

RESULTS

Exploratory laparotomy revealed intestinal intussusception and a 4 cm lesion on the antimesenteric border, suspected to be a tumor. A segmental resection with primary anastomosis was performed, resulting in a favorable postoperative recovery. Histopathological and immunohistochemical analyses confirmed poorly differentiated metastatic clear cell renal carcinoma.

CONCLUSIONS

This report underscores the need to consider gastrointestinal symptoms in patients with renal carcinoma, as an intestinal metastasis, although rare, is a potential complication. Synchronous metastases are even rarer and present a significant diagnostic challenge.