PMC4531661_01
Abdominopelvic CT scan. (A) Circumferential wall thickening with high enhancement in the second portion of the duodenum. (B) Enhancement of an irregular protruding mass into the lumen of the ascending colon.
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An abdominopelvic CT scan showed circumferential wall thickening with high enhancement at the second portion of the duodenum and additional enhancement of an irregular protruding mass into the lumen of the ascending colon with multiple lymphadenopathy in the aortocaval area (Figure 1).
Endoscopy. (A) A gastroscopic view shows an irregular multi-lobed, partially ulcerative and protruding mass nearly obstructing the second portion of the duodenum. (B) A colonoscopic view shows a purplish-colored, sharp-margined and nodular mass on the ascending colon.
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A colonoscopy revealed a polypoid, nodular mass in the ascending colon, which was purplish in color, had sharp margins and was pliable (Figure 2).
Pathology. (A) Mixed clear and granular cell type renal cell carcinoma in the nephrectomy specimen 4 years ago (H&E X200). (B) Renal cell carcinoma in duodenal tumor (H&E X200). (C) Positive immunohistochemical stain for vimentin in duodenal tumor X200).
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Microscopic findings of biopsy specimens showed features identical to those of the renal cell carcinoma which was resected 4 years earlier in this patient and immunohistochemical stainings for vimentin was positive (Figure 3).