Abstract
A 41-year-old man who had intestinal malrotation was presented with left renal tumor. The tumor extended venous thrombus up to hepatic portion and showed invasion in vessels and lymph nodes of mesocolon, which extended to porta hepatis. Needle biopsy of the renal tumor showed glandular adenocarcinoma. While colon cancer metastasis was possible, adenocarcinoma or glandular differentiation of urothelial carcinoma of the renal pelvis was also likely. The disease progressed rapidly and the patient died in a few months after the initial hospital visit. The very uncommon pattern of disease progression in this case was considered to be associated with intestinal malrotation, which is characterized by unfixed short mesenterium, abnormal alignment of mid- and hind-guts, and the lack of normal anatomical structures between peritoneum and retroperitoneum including the ligament of Treiz. This case provides an important implication of intestinal malrotation in disease progression, which may affect clinical decision-making in the extent of surgical resection including lymph node dissection.
Similar content being viewed by others
References
Torres AM, Ziegler MM (1993) Malrotation of the intestine. World J Surg 17:326–331
Devlin HB, Williams RS, Pierce JW (1968) Presentation of midgut malrotation in adults. Br Med J 1:803–807
von Flue M, Herzog U, Ackermann C et al (1994) Acute and chronic presentation of intestinal nonrotation in adults. Dis Colon Rectum 37:192–198
Kantor JL (1934) Anomalies of the colon: their roentgen diagnosis and clinical significance. Radiology 23:651–662
Nehra D, Goldstein AM (2011) Intestinal malrotation: varied clinical presentation from infancy through adulthood. Surgery 149:386–393
Ren PT, Lu BC (2009) Intestinal malrotation associated with colon cancer in an adult: report of a case. Surg Today 39:624–627
Nakayama Y, Akiyama M, Sawatsubashi Y, et al (2016) A case of advanced descending colon cancer in an adult patient with intestinal malrotation. Case Rep Gastrointest Med 2016:3194056
Alvarez Seoane R, Garcia Novoa A, Gomez Gutierrez M (2014) Obstructive jaundice caused by a mucinous adenocarcinoma of the appendix in a patient with intestinal malrotation. Cir Esp 92:131–133
Aksu G, Fayda M, Sakar B et al (2003) Colon cancer with isolated metastasis to the kidney at the time of initial diagnosis. Int J Gastrointest Cancer 34:73–77
Huang H, Tamboli P, Karam JA et al (2016) Secondary malignancies diagnosed using kidney needle core biopsies: a clinical and pathological study of 75 cases. Hum Pathol 52:55–60
August DA, Ottow RT, Sugarbaker PH (1984) Clinical perspective of human colorectal cancer metastasis. Cancer Metastasis Rev 3:303–324
Tseng YS, Chen KH, Chiu B et al (2010) Renal urothelial carcinoma with extended venous thrombus. South Med J 103:813–814
Pouliot F, Shuch B, Larochelle JC et al (2010) Contemporary management of renal tumors with venous tumor thrombus. J Urol 184:833–841 quiz 1235
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Ito, K., Kobayashi, T., Koyama, T. et al. Left renal mass presenting uncommon pattern of extension in a patient with intestinal malrotation. Int Canc Conf J 6, 88–91 (2017). https://doi.org/10.1007/s13691-017-0282-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13691-017-0282-1