Bilateral Papillary Renal Cell Carcinoma (RCC) Associated with Gastrointestinal Stromal Tumor (GIST)

Abstract

Purpose: Abstract: An association of GIST with other tumor has been previously reported in literature. However, we report the first case of synchronous occurrence of GIST and bilateral papillary (RCC). 50-year old male admitted with complain of dizziness and passing black stool for last 2 weeks. Physical examination was significant for positive occult blood testing and Lab showed microcytic hypochromic anemia. Both endoscopy and colonoscopy were negative. CT abdomen showed a large mass involving the small bowel along with lesions on both kidney and questionable bone lesion in his pelvis. Barium study findings were suggestive of an intramural mass with predominantly exophytic components. Laproscopic resection of the intestinal mass reveals the tumor size of 8 cm and biopsy confirms the diagnosis of GIST. MRI of the kidney confirmed bilateral kidney lesion and biopsy of the right renal mass confirms the diagnosis of papillary renal cell carcinoma type I low grade. Discussion: GISTs are mesenchymal neoplasms of the gastrointestinal and showed association with multiple malignancies including like gastric, colorectal, hepatocellular adenocarcinoma, carcinoid, gastric lymphoma, and ampulla of vater. Four case report of unilateral papillary renal cell carcinoma synchronous with GIST has been previously reported. The association of GIST with multiple tumors necessitates the investigation of second tumor once it is diagnosed. Though rare but it should be among the differential diagnosis of bleeding per rectum when there is no evident cause.