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Clinical Notes
June 9, 1978

Renal Carcinoma Simulating Colon Carcinoma

Author Affiliations

From the Veterans Administration Lakeside Hospital and Northwestern University, Chicago (Drs Morin and Baker) and Loyola University Hospital, Maywood (Dr Marsan).

JAMA. 1978;239(23):2476. doi:10.1001/jama.1978.03280500072028

DIRECT invasion of adjacent colon by contiguous hypernephroma is seldom clinically notable, but it is occasionally identified during nephrectomy for locally advanced lesions,1 and in recurrence of previously resected hypernephromas.2,3 In such instances, the renal origin of the lesion is generally evident. It is rare for an otherwise occult hypernephroma to be diagnosed as a primary colon carcinoma. Failure to recognize the renal origin of the lesion before surgery can result in extensive improperly directed surgery.

Report of a Case  A 61-year-old man complained of abdominal distension and epigastric pain progressing during a two-month period, anorexia, and a 14-kg weight loss. Pertinent physical findings included hepatomegaly and mild tenderness in the epigastrium where there was a suggestion of a mass. The stool was guaiac negative, and findings of the urinalysis were normal. The hemoglobin level was 7.7 g/dl, and the hematocrit volume was 25%.A barium enema examination