Adult small-intestinal intussusception is rare and very different from childhood intussusception. Both benign and malignant pathologies can underlie small intestinal intussusception in adults, but malignancy is much less frequent. We report a case of jejunojejunal intussusception caused by an intestinal metastasis of the sarcomatoid component of pleomorphic carcinoma of the right lung. The patient, a 61-year-old man, underwent successful segmental jejunal resection. Adult small bowel intussusception, though an unusual cause of acute abdomen, requires early diagnosis and timely management. To our knowledge, this is the first report of adult jejunojejunal double intussusception caused by metastatic sarcomatoid carcinoma of the lung.

Adult jejunojejunal intussusception caused by metastasized pleomorphic carcinoma of the lung: report of a case.

Renal cell carcinoma (RCC) may metastasize to almost any organ, but metastasis to the small bowel is rare. Small bowel metastasis from RCC can induce obstruction or bleeding, and perforation can also be induced in rare case. Yet RCC metastasis to the small bowel is unlikely to be a direct cause of intussusceptions. A few cases of intussusceptions caused by small intestinal metastasis of RCC have been reported, but multiple small intestinal intussusceptions are extremely rare. We report here on a 47-year-old male patient who presented to the emergency room with acute abdominal pain. He had undergone radical nephrectomy 2 years previously due to left RCC. The abdominal CT scan revealed enhanced masses with the "target" sign that suggested enteric intussusceptions in the jejunum. Eight pedunculated masses within the small intestinal lumen led to intussusceptions at 30 and 150 cm distal to Treitz ligament. Three segmental resections of the small intestine and functional end to end anastomosis were done. The patient recovered uneventfully from this operation. To the best of our knowledge, this is the 1(st) report of metastases from RCC that presented as synchronous intraluminal polypoid tumors, and these tumors served as the lead points for two intussusceptions in the jejunum.

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A Case of Multiple Intussusceptions in the Small Intestine Caused by Metastatic Renal Cell Carcinoma

Intestinal metastases of renal cell carcinoma (RCC) are very uncommon and only a few cases have been reported in the literature to date. The interval from diagnosis of the primary tumor to clinical presentation of small bowel metastases is variable and it seems to correlate with overall survival. Symptoms include abdominal pain, bleeding, perforation, and/or obstruction by an intussusception mechanism. The optimal treatment remains controversial and it depends on clinical patient’s conditions, comorbidities, and the pattern of tumor diffusion. The management should be aggressive since metastasectomy may extend patient survival. We report a rare case of a patient with a history of metachronous bilateral RCC and asymptomatic adrenal pheochromocytoma who developed, 1 year after a solitary metastasis in the proximal phalanx of the big toe, which was surgically removed, two metachronous ileum metastases. After a radical resection of these lesions, a standard second-line therapy with everolimus was started leading to a prolonged disease stabilization and survival. Case Report

Atypical Multiple Ileum Metastases of Renal Cell Carcinoma

Abstract Metastases from renal cell carcinoma (RCC) are rarely located in the small bowel and usually present either with iron deficiency anaemia due to occult bleeding or obstructive symptoms. A 65-year-old man with not known malignancy was admitted to our hospital with symptoms of intermittent bowel obstruction. The abdominal computed tomography (CT) scan depicted a large tumour of the right kidney and obstruction of the small intestine at the level of the proximal jejunum. A jejuno-jejunal intussusception was found on laparotomy, due to endoluminal lesions that proved to be metastatic from RCC. Intussusception of the small bowel due to metastatic RCC is a very rare combination and only a few such cases have been reported so far in the literature.

Small bowel intussusception due to metastatic renal cell carcinoma

This case report presents a unique instance of small bowel perforation caused by solitary metastasis from renal cell carcinoma (RCC), a rare and complex clinical scenario. The patient, a 59-year-old male with a history of RCC treated with nephrectomy four years prior, presented with acute abdomen symptoms. Emergency diagnostic procedures identified a significant lesion in the small intestine. Surgical intervention revealed a perforated jejunal segment due to metastatic RCC. Postoperatively, the patient developed complications, including pneumonia and multi-organ failure, leading to death 10 days after surgery. Histopathological analysis confirmed the metastatic nature of the lesion. This case underscores the unpredictable nature of RCC metastasis and highlights the need for vigilance in post-nephrectomy patients. The rarity of small bowel involvement by RCC metastasis, particularly presenting as perforation, makes this case a significant contribution to medical literature, emphasizing the challenges in the diagnosis and management of such atypical presentations.

Small Bowel Perforation Due to Renal Carcinoma Metastasis: A Comprehensive Case Study and Literature Review

Small bowel secondaries from renal cell carcinoma are rare. Patients usually present with features of intestinal obstruction or GI bleeding. Management should be aggressive since metastasectomy can improve the quality of life and survival.

Intussusception due to ileal metastases from renal cell carcinoma.

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Intussusception due to ileal metastases from renal cell carcinoma.