Metastatic Jejunal Renal Cell Carcinoma Intussusception Presenting as Melena

Area of Science:

• Oncology
• Gastroenterology
• Surgical Pathology

Background:

• Renal cell carcinoma (RCC) typically metastasizes to the lungs, with small bowel involvement being uncommon.
• Gastrointestinal (GI) bleeding is a frequent presentation of small bowel metastasis.
• Small bowel intussusception can rarely be caused by a metastatic mass acting as a lead point.

Observation:

• A male patient presented with melena as his primary symptom, denying abdominal pain or nausea.
• Push enteroscopy identified a jejunal mass.
• Computed tomography (CT) revealed small bowel intussusception.

Findings:

• Histopathology confirmed the jejunal mass to be metastatic renal cell carcinoma.
• The patient underwent surgical resection and anastomosis for the condition.

Implications:

• This case highlights the diagnostic utility of push enteroscopy for detecting small bowel metastasis from RCC.
• Early diagnosis and intervention are crucial for managing rare metastatic presentations of RCC.
• Understanding rare metastatic patterns aids in comprehensive patient care and treatment strategies.