Korean J Radiol.  2017 Jun;18(3):452-460. 10.3348/kjr.2017.18.3.452.

Gastrointestinal Involvement of Recurrent Renal Cell Carcinoma: CT Findings and Clinicopathologic Features

Affiliations
  • 1Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea. leesoolbee@hanmail.net
  • 2Department of Radiology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung 25440, Korea.

Abstract


OBJECTIVE
To retrospectively evaluate the CT findings and clinicopathologic features in patients with gastrointestinal (GI) involvement of recurrent renal cell carcinoma (RCC).
MATERIALS AND METHODS
The medical records were reviewed for 15 patients with 19 pathologically proven GI tract metastases of RCC. The CT findings were analyzed to determine the involved sites and type of involvement; lesion size, morphology, and contrast enhancement pattern; and occurrence of lymphadenopathy, ascites and other complications.
RESULTS
The most common presentation was GI bleeding (66.7%). The average interval between nephrectomy and the detection of GI involvement was 30.4 ± 37.4 months. GI lesions were most commonly found in the ileum (36.8%) and duodenum (31.6%). A distant metastasis (80%) was more common than a direct invasion from metastatic lesions. The mean lesion size was 34.1 ± 15.0 mm. Intraluminal polypoid masses (63.2%) with hyperenhancement (78.9%) and heterogeneous enhancement (63.2%) were the most common findings. No patients had regional lymphadenopathy. Complications occurred in four patients, with one each of bowel obstruction, intussusception, bile duct dilatation, and pancreatic duct dilatation.
CONCLUSION
GI involvement of recurrent RCC could be included in the differential diagnosis of patients with heterogeneous, hyperenhanced intraluminal polypoid masses in the small bowel on CT scans along with a relative paucity of lymphadenopathy.

Keyword

Gastrointestinal tract; Renal cell carcinoma; Metastasis; Computed tomography
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