Synchronous Jejunal Metastasis Presenting as Intussusception in a Case of Advanced RCC: a Rare Presentation

Area of Science:

• Oncology
• Gastroenterology
• Surgical Pathology

Background:

• Renal cell carcinoma (RCC) commonly metastasizes to various organs, but small bowel involvement is exceptionally uncommon.
• The intrinsic resistance of the small bowel wall to metastatic seeding from RCC remains poorly understood.
• Small bowel metastases from RCC can lead to severe complications including obstruction, bleeding, and perforation.

Purpose of the Study:

• To report an extremely rare case of small bowel intussusception caused by a solitary metastasis from renal cell carcinoma.
• To describe the clinical presentation and successful surgical management of this rare oncological emergency.
• To contribute to the limited existing literature on small bowel intussusception secondary to metastatic RCC.

Main Methods:

• Case report detailing a patient with metastatic renal cell carcinoma presenting with intussusception.
• Diagnostic workup including imaging to identify the primary tumor and the small bowel metastasis.
• Surgical intervention involving simultaneous radical nephrectomy, resection of the affected jejunal segment, and anastomosis.

Main Results:

• A solitary metastasis of renal cell carcinoma was identified as the cause of intussusception in the jejunum.
• The patient underwent successful simultaneous surgical procedures for both the primary renal tumor and the small bowel metastasis.
• This represents one of the few reported cases worldwide of small bowel intussusception due to metastatic RCC.

Conclusions:

• Small bowel intussusception, though rare, is a potential presentation of metastatic renal cell carcinoma.
• Prompt surgical intervention combining nephrectomy and bowel resection can be curative in selected cases.
• Further research is needed to elucidate the factors contributing to the low incidence of small bowel metastasis in RCC.