Renal cell carcinoma (RCC) is a diverse collection of malignancies that arise from renal tubular epithelial cells and is one of the top 10 malignancies in the world [6]. RCC incidence rises sharply with age, and males have a greater rate than women. In the United States, rates vary by ethnic group, with Native Americans and African Americans having the highest rates, and Asian Americans having the lowest [7]. Excess body weight, hypertension, and cigarette smoking are all known risk factors for RCC [6], and they were found to be factors in around half of all identified cases in one US investigation.
Patients with RCC experience a wide range of symptoms, while many stay asymptomatic until the disease has progressed [8]. The typical triad of flank discomfort, hematuria, and flank mass is rare (10% of cases) and usually indicates severe illness. Despite the fact that new imaging measures have made the diagnosis of renal tumors more prevalent, patients still arrive with systemic illness and a variety of symptoms, the most prevalent of which is haematuria and/or groin pain. Approximately 25% of patients had distant metastases or severe local-regional illness at the time of presentation. Other patients, even those with merely localized illness, have a wide range of symptoms and/or aberrant test results. Because of this, it is also called “Internist’s tumor” [8]. The abundance of blood supply in the kidneys raises the likelihood of RCC metastases [9]. The most common metastasis is to the lung, lymph nodes, liver, bones, and brain. Although colonic metastasis in RCC is uncommon, cancer can spread throughout the gastrointestinal system, and there is no one lymphatic or hematogenous route that may adequately explain colonic metastasis. Colonic metastasis can occur in a variety of locations, although the sigmoid, splenic flexure, transverse colon, and hepatic flexure are the most prevalent [10].
Distinguishing primary vesicular cancers from metastatic lesions using CT scan is challenging, necessitating biopsy and immunohistochemistry for diagnostic confirmation [11]. Higher carcinoembryonic antigen (CEA) and cytokeratin 7 (CK7) levels, slightly increased CK10 levels, have been identified in primary tumors. Increased vimentin are detected in instances with RCC metastases, with negative CL7 findings [15]. Thumb-printing on an abdominal radiograph and segmental wall thickening on a CT scan are two signs of malignancy-related inflammation and edema, neither of which was seen in this patient. Intestinal metastases are typically detected as a result of a specific clinical manifestation, such as nausea, stomach discomfort, bleeding, melaena, or blockage [13].
Because of the higher metastasis rate, management of the RCC requires a multidisciplinary approach. Both the National Comprehensive Cancer Network and American Urology Association suggest routine postoperative surveillance for the first 5 years [9]. The prognosis of patients with metastatic RCC has improved in recent years, thanks to the introduction of targeted treatments [13]. However, surgical excisions of isolated metastases continue to play a role in the treatment of metastatic RCC in the absence of remarkable outcomes [14].