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Peer-reviewedCC BY 4.0Frontiers in Oncology

Case Report: Metachronous colon metastasis of clear-cell renal cell carcinoma seven years after radical nephrectomy

  • Yuhang Tian1
  • Xinchun Wu1
  • Yongbai Li2
  • Zhidong Gao1
  • Kewei Jiang1
  • Yingjiang Ye1
  • Yichao Yan3
  1. 1Department of Gastrointestinal Surgery, Peking University People’s Hospital
  2. 2Department of General Surgery, Guizhou Provincial People’s Hospital
  3. 3Department of Gastrointestinal Surgery, Peking University International Hospital
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Abstract

Colon metastasis from renal cell carcinoma (RCC) is rare and can remain diagnostically elusive when the lesion is predominantly intramural. In this case, we present a 66-year-old man with melena and anorexia. He had undergone left radical nephrectomy for stage I clear-cell renal cell carcinoma (ccRCC) seven years earlier. Computed tomography showed a 5.2 × 4.0 cm mass in ileocecal colon, causing ileal obstruction, with multiple pulmonary nodules. Serum CEA, CA 19-9, and AFP levels were within normal ranges. Colonoscopy described a friable hemorrhagic lesion near the ileocecal valve, but six biopsy specimens from two examinations showed only necrotic tissue. PET-CT findings supported malignancy, and right hemicolectomy was performed. Pathology identified a 5.5 × 5.0 cm clear-cell malignant tumor with full-thickness intestinal wall infiltration. Immunohistochemistry supported metastatic clear-cell RCC. No abdominal recurrence was detected one year later, but pulmonary nodules progressed and the patient died of pulmonary embolism two years after colectomy. This case underscores the need to consider metachronous RCC metastasis in bleeding or obstructing colonic masses after nephrectomy, even when endoscopic biopsy and serum tumor markers are non-diagnostic.

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Cite

BibTeXRIS
BibTeX
@article{tian2026case,
  title = {{Case Report: Metachronous colon metastasis of clear-cell renal cell carcinoma seven years after radical nephrectomy}},
  author = {Yuhang Tian and Xinchun Wu and Yongbai Li and Zhidong Gao and Kewei Jiang and Yingjiang Ye and Yichao Yan},
  journal = {Frontiers in Oncology},
  year = {2026},
  month = oct,
  doi = {10.3389/fonc.2026.1948977},
  url = {https://www.frontiersin.org/articles/10.3389/fonc.2026.1948977/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Case Report: Metachronous colon metastasis of clear-cell renal cell carcinoma seven years after radical nephrectomy
AU  - Yuhang Tian
AU  - Xinchun Wu
AU  - Yongbai Li
AU  - Zhidong Gao
AU  - Kewei Jiang
AU  - Yingjiang Ye
AU  - Yichao Yan
PY  - 2026
DA  - 2026/10/28
JO  - Frontiers in Oncology
DO  - 10.3389/fonc.2026.1948977
UR  - https://www.frontiersin.org/articles/10.3389/fonc.2026.1948977/full
AB  - Colon metastasis from renal cell carcinoma (RCC) is rare and can remain diagnostically elusive when the lesion is predominantly intramural. In this case, we present a 66-year-old man with melena and anorexia. He had undergone left radical nephrectomy for stage I clear-cell renal cell carcinoma (ccRCC) seven years earlier. Computed tomography showed a 5.2 × 4.0 cm mass in ileocecal colon, causing ileal obstruction, with multiple pulmonary nodules. Serum CEA, CA 19-9, and AFP levels were within normal ranges. Colonoscopy described a friable hemorrhagic lesion near the ileocecal valve, but six biopsy specimens from two examinations showed only necrotic tissue. PET-CT findings supported malignancy, and right hemicolectomy was performed. Pathology identified a 5.5 × 5.0 cm clear-cell malignant tumor with full-thickness intestinal wall infiltration. Immunohistochemistry supported metastatic clear-cell RCC. No abdominal recurrence was detected one year later, but pulmonary nodules progressed and the patient died of pulmonary embolism two years after colectomy. This case underscores the need to consider metachronous RCC metastasis in bleeding or obstructing colonic masses after nephrectomy, even when endoscopic biopsy and serum tumor markers are non-diagnostic.
SN  - 2234-943X
ER  -