Renal cell carcinoma presenting as nonspecific gastrointestinal symptoms: a case report.
Identifieur interne : 000656 ( Main/Exploration ); précédent : 000655; suivant : 000657Renal cell carcinoma presenting as nonspecific gastrointestinal symptoms: a case report.
Auteurs : Utkarsh Ojha [Royaume-Uni] ; Vinod Ojha [Royaume-Uni]Source :
- International medical case reports journal [ 1179-142X ] ; 2018.
Abstract
Background
Renal cell carcinoma (RCC) arises from the renal epithelium and accounts for more than 90% of kidney cancers. RCC has a diverse range of clinical manifestations. The classical triad of loin pain, hematuria and abdominal mass is only present in 4%-17% of cases. Here, we demonstrate a unique case of RCC presenting as upper gastrointestinal (GI) symptoms without any specific GI involvement.
Case presentation
A 49-year-old man, presented with ongoing severe heartburn, nausea and vomiting for 5 months. The patient further complained of weight loss over the last 2 months. Routine blood tests were normal except raised C-reactive protein and ALP. Examination revealed a large and tender liver, and he was subsequently referred under the upper GI cancer pathway. Esophagogastroduodenoscopy showed hiatus hernia and gastritis. CT scan revealed an 11 and 9 mm nodule in the left and right lung, respectively. There was a further metastatic 13×7 cm
Conclusion
The classical triad of loin pain, hematuria and abdominal mass for RCC is not that common and RCC should be suspected in patients complaining of upper GI pain with nonspecific symptoms. Furthermore, it is not necessary that patients complaining of "heartburn" have a GI cause, as pathology in other thoracic organs present in a similar manner.
DOI: 10.2147/IMCRJ.S178816
PubMed: 30568516
PubMed Central: PMC6267697
Affiliations:
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RCC has a diverse range of clinical manifestations. The classical triad of loin pain, hematuria and abdominal mass is only present in 4%-17% of cases. Here, we demonstrate a unique case of RCC presenting as upper gastrointestinal (GI) symptoms without any specific GI involvement.</p></div><div type="abstract" xml:lang="en"><p><b>Case presentation</b></p><p>A 49-year-old man, presented with ongoing severe heartburn, nausea and vomiting for 5 months. The patient further complained of weight loss over the last 2 months. Routine blood tests were normal except raised C-reactive protein and ALP. Examination revealed a large and tender liver, and he was subsequently referred under the upper GI cancer pathway. Esophagogastroduodenoscopy showed hiatus hernia and gastritis. CT scan revealed an 11 and 9 mm nodule in the left and right lung, respectively. There was a further metastatic 13×7 cm</p></div><div type="abstract" xml:lang="en"><p><b>Conclusion</b></p><p>The classical triad of loin pain, hematuria and abdominal mass for RCC is not that common and RCC should be suspected in patients complaining of upper GI pain with nonspecific symptoms. Furthermore, it is not necessary that patients complaining of "heartburn" have a GI cause, as pathology in other thoracic organs present in a similar manner.</p></div></front></TEI><pubmed><MedlineCitation Status="PubMed-not-MEDLINE" Owner="NLM"><PMID Version="1">30568516</PMID><DateRevised><Year>2020</Year><Month>09</Month><Day>29</Day></DateRevised><Article PubModel="Electronic-eCollection"><Journal><ISSN IssnType="Print">1179-142X</ISSN><JournalIssue CitedMedium="Print"><Volume>11</Volume><PubDate><Year>2018</Year></PubDate></JournalIssue><Title>International medical case reports journal</Title><ISOAbbreviation>Int Med Case Rep J</ISOAbbreviation></Journal><ArticleTitle>Renal cell carcinoma presenting as nonspecific gastrointestinal symptoms: a case report.</ArticleTitle><Pagination><MedlinePgn>345-348</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.2147/IMCRJ.S178816</ELocationID><Abstract><AbstractText Label="Background" NlmCategory="UNASSIGNED">Renal cell carcinoma (RCC) arises from the renal epithelium and accounts for more than 90% of kidney cancers. RCC has a diverse range of clinical manifestations. The classical triad of loin pain, hematuria and abdominal mass is only present in 4%-17% of cases. Here, we demonstrate a unique case of RCC presenting as upper gastrointestinal (GI) symptoms without any specific GI involvement.</AbstractText><AbstractText Label="Case presentation" NlmCategory="UNASSIGNED">A 49-year-old man, presented with ongoing severe heartburn, nausea and vomiting for 5 months. The patient further complained of weight loss over the last 2 months. Routine blood tests were normal except raised C-reactive protein and ALP. Examination revealed a large and tender liver, and he was subsequently referred under the upper GI cancer pathway. Esophagogastroduodenoscopy showed hiatus hernia and gastritis. CT scan revealed an 11 and 9 mm nodule in the left and right lung, respectively. There was a further metastatic 13×7 cm<sup>2</sup> mass in the liver and 10×8 cm<sup>2</sup> mass arising from the upper pole of the left kidney with convincing evidence of tumor thrombus in left renal vein. The patient was promptly referred under the care of the oncologist team and died within months.</AbstractText><AbstractText Label="Conclusion" NlmCategory="UNASSIGNED">The classical triad of loin pain, hematuria and abdominal mass for RCC is not that common and RCC should be suspected in patients complaining of upper GI pain with nonspecific symptoms. Furthermore, it is not necessary that patients complaining of "heartburn" have a GI cause, as pathology in other thoracic organs present in a similar manner.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Ojha</LastName><ForeName>Utkarsh</ForeName><Initials>U</Initials><AffiliationInfo><Affiliation>Imperial College School of Medicine, Imperial College London, London, UK, utkarsh.ojha13@imperial.ac.uk.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ojha</LastName><ForeName>Vinod</ForeName><Initials>V</Initials><AffiliationInfo><Affiliation>Willow Bank Surgery, NHS, Stoke-on-Trent, UK.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D002363">Case Reports</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2018</Year><Month>11</Month><Day>27</Day></ArticleDate></Article><MedlineJournalInfo><Country>New Zealand</Country><MedlineTA>Int Med Case Rep J</MedlineTA><NlmUniqueID>101566269</NlmUniqueID><ISSNLinking>1179-142X</ISSNLinking></MedlineJournalInfo><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">gastrointestinal</Keyword><Keyword MajorTopicYN="N">kidney cancer</Keyword><Keyword MajorTopicYN="N">metastasis</Keyword><Keyword MajorTopicYN="N">renal cell carcinoma</Keyword></KeywordList><CoiStatement>Disclosure The authors report no conflicts of interest in this work.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2018</Year><Month>12</Month><Day>21</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2018</Year><Month>12</Month><Day>21</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2018</Year><Month>12</Month><Day>21</Day><Hour>6</Hour><Minute>1</Minute></PubMedPubDate></History><PublicationStatus>epublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">30568516</ArticleId><ArticleId IdType="doi">10.2147/IMCRJ.S178816</ArticleId><ArticleId IdType="pii">imcrj-11-345</ArticleId><ArticleId IdType="pmc">PMC6267697</ArticleId></ArticleIdList><ReferenceList><Reference><Citation>World J Urol. 2005 Jul;23(3):202-12</Citation><ArticleIdList><ArticleId IdType="pubmed">15812574</ArticleId></ArticleIdList></Reference><Reference><Citation>Br J Urol. 1949 Jun;21(2):128-51</Citation><ArticleIdList><ArticleId IdType="pubmed">18145509</ArticleId></ArticleIdList></Reference><Reference><Citation>BJU Int. 2008 Aug;102(3):315-9</Citation><ArticleIdList><ArticleId IdType="pubmed">18336607</ArticleId></ArticleIdList></Reference><Reference><Citation>Urol Ann. 2010 Sep;2(3):127-9</Citation><ArticleIdList><ArticleId IdType="pubmed">20981203</ArticleId></ArticleIdList></Reference><Reference><Citation>World J Surg Oncol. 2012 Sep 25;10:199</Citation><ArticleIdList><ArticleId IdType="pubmed">23009644</ArticleId></ArticleIdList></Reference><Reference><Citation>Int Surg. 2014 Jan-Feb;99(1):86-90</Citation><ArticleIdList><ArticleId IdType="pubmed">24444276</ArticleId></ArticleIdList></Reference><Reference><Citation>BMJ. 2014 Nov 10;349:g4797</Citation><ArticleIdList><ArticleId IdType="pubmed">25385470</ArticleId></ArticleIdList></Reference><Reference><Citation>BMJ Case Rep. 2015 Aug 14;2015:null</Citation><ArticleIdList><ArticleId IdType="pubmed">26276850</ArticleId></ArticleIdList></Reference><Reference><Citation>Int J Surg Case Rep. 2015;15:130-2</Citation><ArticleIdList><ArticleId IdType="pubmed">26348395</ArticleId></ArticleIdList></Reference><Reference><Citation>Nat Rev Dis Primers. 2017 Mar 09;3:17009</Citation><ArticleIdList><ArticleId IdType="pubmed">28276433</ArticleId></ArticleIdList></Reference><Reference><Citation>World J Oncol. 2010 Aug;1(4):149-157</Citation><ArticleIdList><ArticleId IdType="pubmed">29147198</ArticleId></ArticleIdList></Reference><Reference><Citation>J Urol. 1979 Sep;122(3):306-9</Citation><ArticleIdList><ArticleId IdType="pubmed">469999</ArticleId></ArticleIdList></Reference></ReferenceList></PubmedData></pubmed><affiliations><list><country><li>Royaume-Uni</li></country></list><tree><country name="Royaume-Uni"><noRegion><name sortKey="Ojha, Utkarsh" sort="Ojha, Utkarsh" uniqKey="Ojha U" first="Utkarsh" last="Ojha">Utkarsh Ojha</name></noRegion><name sortKey="Ojha, Vinod" sort="Ojha, Vinod" uniqKey="Ojha V" first="Vinod" last="Ojha">Vinod Ojha</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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