Are gastric metastases of renal cell carcinoma really rare? A case report and systematic review of the literature

Thomas Prudhomme; Charlotte Maulat; Guillaume Péré; Fatima-Zohra Mokrane; Michel Soulié; Fabrice Muscari

doi:10.1016/j.ijscr.2021.105867

Are gastric metastases of renal cell carcinoma really rare? A case report and systematic review of the literature

Int J Surg Case Rep. 2021 May:82:105867. doi: 10.1016/j.ijscr.2021.105867. Epub 2021 Apr 6.

Authors

Thomas Prudhomme¹, Charlotte Maulat², Guillaume Péré², Fatima-Zohra Mokrane³, Michel Soulié⁴, Fabrice Muscari²

Affiliations

¹ Department of Digestive Surgery, Toulouse University Hospital, 31059, Toulouse, France; Department of Urology and Kidney Transplantation, Toulouse University Hospital, 31059, Toulouse, France. Electronic address: prudhomme.t@chu-toulouse.fr.
² Department of Digestive Surgery, Toulouse University Hospital, 31059, Toulouse, France.
³ Department of Radiology, Toulouse University Hospital, 31059, Toulouse, France.
⁴ Department of Urology and Kidney Transplantation, Toulouse University Hospital, 31059, Toulouse, France.

Abstract

Introduction: Renal cell carcinoma (RCC) represents above 3 % of all cancers. At diagnosis, above 25 % of patients with RCC present an advanced disease. Gastric metastasis of RCC is associated with poor outcome. We report the case of a patient treated for a gastric metastasis of RCC and we conducted a systematic review of the literature to report all published cases of RCC patients with gastric metastasis.

Case presentation: In December 2010, a 61-year-old man was treated by open partial nephrectomy for a localized right clear cell RCC. In September 2018, a metachronous gastric metastasis was found on CT scan. The lesion was located on the lesser curvature of the stomach, measuring 4.5 cm long axis. No other secondary lesions were identified. A laparoscopic wedge resection, converted to laparotomy was performed. Two years later, in September 2020, a CT scan was performed, revealing a 17 mm adenopathy behind the hepatic hilum and a surgical management was performed, including a lymph node dissection of the hepatic hilum and the hepatic artery. Actually, he remains healthy.

Clinical discussion and conclusion: Our systematic review suggests that solitary gastric metastasis of RCC are scarce. In comparison of patients with multiple metastatic sites, the median survival of patients with solitary gastric metastasis is longer.

Keywords: Case report; Gastric metastases; Metastatic recurrence; Renal cell carcinoma; Surgical treatment; Systemic treatment.