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Gao TZ, Zheng CZ, Zhu KK, Wu XN, He CY, Lou YM, Liu XS. Gastric metastasis from renal cell carcinoma with a 10-year interval: A case report. World J Gastrointest Surg 2026; 18(11): 124761 [DOI: 10.4240/wjgs.124761]
Tian-Zhe Gao, Chi-Yu He, Yu-Ming Lou, Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang Province, China
Chao-Ze Zheng, Kan-Kai Zhu, Xing-Nan Wu, Xiao-Sun Liu, Department of Gastrointestinal Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang Province, China
Author contributions: Gao TZ contributed to writing - original draft; Zhu KK contributed to resources, writing - review and editing; Wu XN contributed to data curation; Gao TZ and Zheng CZ contributed to investigation; He CY contributed to funding acquisition; Lou YM contributed to methodology; Liu XS contributed to conceptualization; and all authors have read and approved the final manuscript.
AI contribution statement: Portions of this manuscript were edited using AI tools solely for language refinement. The authors carefully reviewed and verified all AI-assisted outputs and take full responsibility for the scientific content of the manuscript.
Supported by the Key Research & Development Plan of Zhejiang Province, No. 2025C02171.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Xiao-Sun Liu, PhD, Department of Gastrointestinal Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 366 Wutong Road, Hangzhou 310000, Zhejiang Province, China. xiaosunliu@zju.edu.cn
Received: June 24, 2026 Revised: August 3, 2026 Accepted: September 9, 2026 Published online: November 27, 2026 Processing time: 141 Days and 20.5 Hours
Abstract
BACKGROUND
Gastric metastasis of renal cell carcinoma (RCC) is rare clinically, often presenting with a prolonged interval (median 7-10 years) between initial diagnosis and metastasis, rendering it prone to imaging oversight.
CASE SUMMARY
We report a 70-year-old man with advanced clear cell RCC (ccRCC) who developed gastric metastasis 10 years after initial radical nephrectomy. After adjuvant therapy with interleukin-2 and treatment of subsequent recurrent left renal pelvis RCC with partial nephrectomy and pazopanib, the patient received penpulimab plus axitinib for metastatic disease. A gastric fundus mass was detected by positron emission tomography/computed tomography during routine follow-up and confirmed as metastatic ccRCC by endoscopic biopsy and immunohistochemistry (PAX-8+, CA IX+, CD10+, CK7-). The patient underwent robot-assisted wedge resection of the stomach in August 2025 and remains on sintilimab maintenance immunotherapy.
CONCLUSION
For advanced RCC, gastric metastasis should remain part of differential diagnosis even in the absence of gastrointestinal symptoms.
Core Tip: Gastric metastasis from renal cell carcinoma is exceedingly rare, with a median latency of 7-10 years after nephrectomy, making it prone to diagnostic oversight. We report a 70-year-old man who developed gastric fundus metastasis 10 years after radical nephrectomy for clear cell renal cell carcinoma. Despite a suspicious computed tomography finding misread as food residue three months earlier, the lesion was confirmed by endoscopic biopsy and resected via robot-assisted wedge gastrectomy. This case underscores that even without gastrointestinal symptoms, gastric metastasis must remain on the differential for advanced renal cell carcinoma patients with prior distant metastases.
