Recurrent renal cell cancer presenting as gastrointestinal bleed

We present an unusual case of renal cell cancer(RCC) which relapsed with duodenal metastasis and unveiled itself by gastrointestinal(GI) bleeding.An 80-year old Caucasian gentleman with history of renal cell cancer status post nephrectomy 11 mo previously,presented with syncope and melena.Computed tomography scan of the abdomen revealed heterogeneous soft tissue mass in the right nephrectomy bed invading the duodenum.Upper GI endoscopic biopsy confirmed the presence of recurrent renal cell cancer.However,due to extensive metastatic disease,the patient was placed on palliative chemotherapy as surgical options were ruled out.Our case report reiterates the fact that renal cell carcinoma can recur with gastrointestinal manifestations and,although a rarity,it should be considered in a patient with a history of malignancy who presents with these symptoms.