Gastric Metastasis From Clear Cell Renal Cell Carcinoma: A Case Report.

Gastric metastases from solid tumors are rare and often clinically silent. When present, they typically originate from primaries such as the lung, breast, or skin. Renal cell carcinoma (RCC), particularly the clear cell subtype, has a known metastatic potential, most commonly to the lungs, bones, and liver. Gastric involvement is extremely uncommon. We report a case of an 83-year-old man with a remote history of clear cell RCC treated with nephrectomy three decades earlier, who presented with melena, epigastric discomfort, and vomiting. Endoscopic evaluation revealed a conglomerate of friable, vegetative lesions in the stomach with signs of recent bleeding. Biopsies confirmed metastasis of clear cell RCC. Computed tomography (CT) imaging demonstrated multiple nodular intraluminal gastric lesions. Given the patient's advanced age, comorbidities, and known distant metastases, surgical treatment was deemed inappropriate. Palliative hemostatic radiotherapy was initiated for symptom control. This case highlights the potential for late gastric metastasis from clear cell RCC and emphasizes the importance of considering metastatic disease in the differential diagnosis of gastrointestinal bleeding, even decades after the initial oncologic treatment. Prompt endoscopic evaluation and histological confirmation are essential for diagnosis, while treatment decisions must be individualized based on disease burden and patient condition.