Recurrent renal cell cancer presenting as gastrointestinal bleed

Table 1 Case series of all reported cases of duodenal metastasis secondary to renal cell cancer

Year	Authors	Years after nephrectomy	Presentation	Diagnosis	Part of duodenum involved	Course and outcome
2007	Haffner	2	Severe anemia, chronic GI bleed	CT scan of abdomen, endoscopy	Second and first	Surgical resection
2006	Segawa	13	Fatigue, weight loss, GI bleed	Endoscopy and biopsy	Second	Palliative care. Died in 5 mo
2006	Bhatia	1	Abdominal lump, Jaundice	Endoscopy and biopsy	Second	Palliative treatment. Lost to follow up
2006	Harish	3	Acute upper GI bleed	Endoscopy and biopsy	Second	En-bloc pancreatico-duodenectomy, no other metastatic lesion, disease free for 2 years
2004	Loualidi	2	Weakness, exertional dyspnea, occult GI blood loss	Endoscopy and biopsy	Second	Palliative radiotherapy. Alive for three years
2004	Chang	9	Acute massive upper GI bleed	Endoscopy and biopsy	Second	Surgery
2002	Lisli	NA	Acute upper GI bleed	Endoscopy and biopsy	Second	Nephrectomy and en-bloc metastasectomy
2001	Mendoza	2	Epigastric pain, Nausea, vomiting	ERCP and biopsy	Second	Necrotizing pancreatitis. Palliative care
2001	Hashimoto	11	Upper GI bleed	Endoscopy and biopsy	Second	Total pancreatectomy and duodenectomy
1999	Yavascaogulu	NA	Flank pain	Endoscopy and biopsy and CT scan	Second	Pylorus preserving pancreaticoduodenectomy. Recurrence free for 1 year
1998	Janzen	17.5	Melena	Endoscopy and biopsy	Second	Total pancreatectomy, duodenectomy, cholystectomy, splenectomy. Discharged home alive
1996	Gastaca	8	Weakness, palpitations, GI bleed	Endoscopy and biopsy	Second	Duodenal resection. Did well for two years
1996	Toh	10	Duodenal obstruction	CT scan and surgical excision biopsy	First and Second	Duodenectomy and discharged
1994	Vesga	9	Acute upper GI bleed	Endoscopy and biopsy	Second	Duodenal and pancreatic resection
1987	Lynch-Nyhan	1	Massive upper GI bleed	Endoscopy and biopsy	Second	Gastroduodenal artery embolization. 6 mo documented survival
		6	Obstructive Jaundice and hematobilia	Endoscopy and biopsy	Second	Gastroduodenal artery embolization. Died 6 mo later
		2	Melena	CT scan	Second	Duodenal and caval extension. Refused treatment

GI: Gastrointestinal; CT: Computed tomography.