We present an unusual case of metastatic renal cell carcinoma (RCC) mimicking diverticulitis in a 76-year-old man with a 16-year history of chronic lymphocytic leukaemia (CLL) and a 2?cm left renal mass.

The patient presented with severe abdominal pain and lower gastrointestinal bleeding with anticoagulation from recent pulmonary embolism. His clinical course was troubled by recurrent hospitalizations and complications that delayed investigations and potential treatments. Radiographic findings revealed stable CLL, mild sigmoid diverticulitis and a small renal mass. Small renal masses (less than 4?cm) are considered low risk for metastasizing and are, thus, often observed or ablated, rather than resected. Furthermore, gastrointestinal metastases from RCC are rare. This case adds new perspective to the unpredictable nature of RCC and how synchronous malignancies may be masked in patients with long-standing CLL.

Written by:
Hwang SM, Kuyava JM, Grande JP, Swetz KM.   Are you the author?
Mayo Medical School, Rochester, Minnesota, USA; Section of Palliative Medicine, Mayo Clinic, Rochester, Minnesota, USA; Department of Pathology, Mayo Clinic, Rochester, Minnesota, USA.

Reference: BMJ Case Rep. 2015 Jan 7;2015. pii: bcr2014206101.
doi: 10.1136/bcr-2014-206101

PubMed Abstract
PMID: 25568267

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