Gastric metastasis of a clear cell renal carcinoma: A case report and review of the literature.

Abstract

Introduction: Clear cell renal carcinoma is the most common type of kidney cancer.

It tends to metastasize, primarily to the lungs, bones, liver, or brain. Gastric metastasis is a rare phenomenon.

The aim of our study is to report a new, rare case of gastric metastasis from clear cell renal carcinoma treated laparoscopically and to review the literature.

Case Report: We report the case of a 53-year-old hypertensive patient who underwent a left nephrectomy in 2018 for clear cell renal carcinoma.

He was hospitalized in gastroenterology for moderate hematemesis that had been present for one year.

Initial endoscopic, CT, and cytological investigations did not reveal any malignancy. Due to persistent symptoms, the patient underwent laparoscopic surgery for a hemorrhagic gastric polyp.

The histopathological and immunohistochemical analysis of the surgical specimen concluded that there was a gastric metastasis of a clear cell renal cancer.

Discussion: Gastric metastasis from clear cell renal carcinoma (CCRC) are rare, accounting for approximately 0.2% to 0.7% of gastric metastasis.

They generally occur several years after radical nephrectomy and may be asymptomatic or present with gastrointestinal symptoms such as abdominal pain, bleeding, or iron deficiency anemia. Upper gastrointestinal endoscopy visualizes lesions (polyps,
ulcerated masses, etc.), and biopsies confirm the diagnosis, often with immunohistochemistry (positivity for CD10, PAX8, etc.).

Treatment for gastric metastasis from clear cell renal carcinoma (CRCC) may include surgical resection, targeted therapy, or immunotherapy, depending on the extent of the disease and the response to treatment.

The prognosis varies according to the location and extent of the metastasis.

Isolated metastasis may have a more favorable prognosis, while multiple metastasis are associated with a less favorable prognosis.

Conclusion: This case illustrates the rarity of gastric metastasis in clear cell renal carcinoma and underscores the importance of regular monitoring in patients with a history of clear cell renal carcinoma.