Renal Cell Carcinoma Masquerading as Acute Upper Gastrointestinal Bleeding
Aadesh Rayamajhi1, Saurav Agrawal1, Sandesh Rayamajhi2
1Maharajgunj Medical Campus, Tribhuvan University, Institute of Medicine, Kathmandu, Nepal.
This case report details a rare instance of upper gastrointestinal bleeding caused by renal cell carcinoma (RCC) invading the duodenum, forming a duodenorenal fistula (DRF). It highlights the need for thorough investigation of gastrointestinal bleeding to uncover uncommon etiologies.
Area of Science:
- Gastroenterology
- Urology
- Oncology
Background:
- Acute upper gastrointestinal bleeding (UGIB) is a common medical emergency, typically caused by peptic ulcer disease or variceal bleeding.
- Malignant invasion of the small intestine causing UGIB is uncommon, with duodenal invasion by renal cell carcinoma (RCC) being exceptionally rare.
Observation:
- A 55-year-old male presented with melena and right flank pain.
- Esophagogastroduodenoscopy (EGD) identified an active bleeding source in the duodenum.
- Contrast-enhanced computed tomography (CECT) revealed a duodenorenal fistula (DRF) secondary to direct extension of RCC.
Findings:
- The imaging confirmed a malignant renal mass infiltrating adjacent organs, leading to the formation of a DRF.
- This rare presentation manifested as acute upper gastrointestinal bleeding.
Implications:
- This case underscores the importance of considering rare diagnoses in patients presenting with gastrointestinal bleeding.
- Comprehensive diagnostic evaluations are crucial for identifying atypical causes of UGIB, such as duodenorenal fistulas from renal cell carcinoma.
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