A case of jejunal hemorrahage from metastatic renal cell carcinoma / 대한내과학회지

ABSTRACT

A 68-year-old man who had suffered left nephrectomy 6 years previously for renal cell carcinoma presented with a 6-week history of melena episodes. Physical examination and laboratory data were irrelevant. Gastroduodenoscopy and colononoscopy could not reveal a bleeding focus. An angiography was undertaken, which confirmed the presence of an abnormal tumor staining at the jejunum. For the preoperative evaluation, a small bowel study showed an about 2 cm sized eccentric filling defect at mesenteric side wall of distal jejunum in the left lower quadrant. A CT scan also showed a heavily enhancing bowel wall thickening. Small bowel resection was performed, and a 3 X 3 cm ulceroinfiltrating jejunal lesion was found which microscopically consisted of a proliferation of trabeculated clear cells. He had an unremarkable postoperative recovery. A follow-up CT scan at 3 months later showed no evidence of recurrence.