Abstract
BACKGROUND: Renal carcinoma is the third most common urological cancer, with 30% of patients presenting with metastases at diagnosis. Metastases to the small intestine are rare (0.7-1.1%), and their presentation as intestinal intussusception is even more uncommon, with only a few cases reported in the literature. AIMS: The aim of the study was to present a case of stage IV clear cell renal carcinoma with a rare presentation of intestinal intussusception, leading to emergency department admission due to severe anemia and melena. METHODS: A 62-year-old man presented with melena for 2 months and a critically low hemoglobin level of 2.9 g/dL (normal range: 13.5-17.5 g/dL). Abdominal and pelvic angiotomography identified an exophytic lesion in the left kidney consistent with renal carcinoma and an approximately 16 cm ileal intussusception. RESULTS: Exploratory laparotomy revealed intestinal intussusception and a 4 cm lesion on the antimesenteric border, suspected to be a tumor. A segmental resection with primary anastomosis was performed, resulting in a favorable postoperative recovery. Histopathological and immunohistochemical analyses confirmed poorly differentiated metastatic clear cell renal carcinoma. CONCLUSIONS: This report underscores the need to consider gastrointestinal symptoms in patients with renal carcinoma, as an intestinal metastasis, although rare, is a potential complication. Synchronous metastases are even rarer and present a significant diagnostic challenge.