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Cancer Imaging

A Case of Small Bowel Obstruction Due to Intraluminal Metastases from Metastatic Renal Cell Cancer

Princess Margaret Hospital and University of Toronto, Department of Medical Oncology and Hematology, Toronto, Ontario, Canada

Key Words. Renal cell cancer • Metastases • Small bowel obstruction

Correspondence: Srikala Sridhar, M.D., M.Sc., F.R.C.P.C., Department of Medicine, Suite 5–222, Princess Margaret Hospital, 610 University Avenue, Toronto, Ontario, M5G 2M9, Canada. Telephone: 416-946-2249; Fax: 416-946-6546; e-mail: srikala.sridhar{at}uhn.on.ca

Disclosure: No potential conflicts of interest were reported by the authors, planners, reviewers, or staff managers of this article.

A 71-year-old man, with a history of metastatic renal cell cancer (RCC), presented with symptoms of a small bowel obstruction with nausea, vomiting, cramps, and diarrhea. He underwent surgery and was found to have intraluminal metastases from his metastatic RCC. Intraluminal metastases are rare and usually present with obstruction, bleeding, or perforation. The mainstay of treatment remains complete surgical excision, even in the face of widely metastatic disease. Surgery not only palliates symptoms, but may also extend survival because metastatic RCC can be a very indolent and unpredictable disease. Furthermore, these patients can now be treated with a new class of antiangiogenic agents that are showing impressive response rates, which may also translate into improved overall survival.