Renal cell carcinoma presenting as acute pancreatitis and GI bleeding

A 75-year-old woman was admitted for acute pancreatitis, jaundice, GI bleeding, and a tender mass in the right hypochondrium. Upper gastrointestinal series demonstrated a diverticulum-like structure on the lateral aspect of the second part of the duodenum. This structure was excised and turned out to be a renal cell carcinoma invading the duodenum by direct extension from the right kidney. Although renal cell carcinoma may present in numerous and often perplexing manifestations, this is a unique presentation.