{"id":"https://openalex.org/W4403720199","doi":"https://doi.org/10.14309/01.ajg.0001049100.88142.10","title":"S4933 Renal Cell Carcinoma: An Unusual Presentation with Melena","display_name":"S4933 Renal Cell Carcinoma: An Unusual Presentation with Melena","publication_year":2024,"publication_date":"2024-10-01","ids":{"openalex":"https://openalex.org/W4403720199","doi":"https://doi.org/10.14309/01.ajg.0001049100.88142.10"},"language":"en","primary_location":{"id":"doi:10.14309/01.ajg.0001049100.88142.10","doi":"https://doi.org/10.14309/01.ajg.0001049100.88142.10","is_oa":false,"landing_page_url":"https://doi.org/10.14309/01.ajg.0001049100.88142.10","pdf_url":null,"source":{"id":"https://openalex.org/S66441642","display_name":"The American Journal of Gastroenterology","issn_l":"0002-9270","issn":["0002-9270","1572-0241"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-b","doyens","jufo-2","ki-jl-2","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"American Journal of Gastroenterology","raw_type":"journal-article"},"volume":null,"type":"conference-abstract","indexed_in":["crossref"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":null,"display_name":"David Weinstein","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I40347166","display_name":"University of Chicago","ror":"https://ror.org/024mw5h28","country_code":"US","type":"education","lineage":["https://openalex.org/I40347166"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"David Weinstein","raw_affiliation_strings":["University of Chicago, NorthShore Internal Medicine, Evanston, IL;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University of Chicago, NorthShore Internal Medicine, Evanston, IL;","institution_ids":["https://openalex.org/I40347166"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5012046842","display_name":"Jeremy Van","orcid":"https://orcid.org/0000-0002-4470-9850","observed_orcids":["https://orcid.org/0000-0002-4470-9850"]},"institutions":[{"id":"https://openalex.org/I40347166","display_name":"University of Chicago","ror":"https://ror.org/024mw5h28","country_code":"US","type":"education","lineage":["https://openalex.org/I40347166"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Jeremy Van","raw_affiliation_strings":["University of Chicago, NorthShore University Health Systems, Chicago, IL;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University of Chicago, NorthShore University Health Systems, Chicago, IL;","institution_ids":["https://openalex.org/I40347166"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5114391283","display_name":"Robert Toelke","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I1339509835","display_name":"Endeavor Health","ror":"https://ror.org/04tpp9d61","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1339509835"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Robert Toelke","raw_affiliation_strings":["NorthShore University HealthSystem, Evanston, IL;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"NorthShore University HealthSystem, Evanston, IL;","institution_ids":["https://openalex.org/I1339509835"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5089728467","display_name":"Mitchelle V. Zolotarevsky","orcid":"https://orcid.org/0009-0006-2279-3250","observed_orcids":["https://orcid.org/0009-0006-2279-3250"]},"institutions":[{"id":"https://openalex.org/I40347166","display_name":"University of Chicago","ror":"https://ror.org/024mw5h28","country_code":"US","type":"education","lineage":["https://openalex.org/I40347166"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Mitchelle V. Zolotarevsky","raw_affiliation_strings":["University of Chicago, NorthShore Internal Medicine, Chicago, IL"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University of Chicago, NorthShore Internal Medicine, Chicago, IL","institution_ids":["https://openalex.org/I40347166"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5111879844","display_name":"Michael Sprang","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I1339509835","display_name":"Endeavor Health","ror":"https://ror.org/04tpp9d61","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1339509835"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Michael Sprang","raw_affiliation_strings":["NorthShore University HealthSystem, Evanston, IL;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"NorthShore University HealthSystem, Evanston, IL;","institution_ids":["https://openalex.org/I1339509835"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":[],"corresponding_institution_ids":["https://openalex.org/I40347166"],"apc_list":{"value":4390,"currency":"USD","value_usd":4390},"apc_paid":null,"fwci":null,"has_fulltext":false,"cited_by_count":1,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":"119","issue":"10S","first_page":"S3108","last_page":"S3109"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10449","display_name":"Renal cell carcinoma treatment","score":0.9833999872207642,"subfield":{"id":"https://openalex.org/subfields/2740","display_name":"Pulmonary and Respiratory Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10449","display_name":"Renal cell carcinoma treatment","score":0.9833999872207642,"subfield":{"id":"https://openalex.org/subfields/2740","display_name":"Pulmonary and Respiratory Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12992","display_name":"Metastasis and carcinoma case studies","score":0.01489999983459711,"subfield":{"id":"https://openalex.org/subfields/2740","display_name":"Pulmonary and Respiratory Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11378","display_name":"Gastrointestinal Bleeding Diagnosis and Treatment","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/2715","display_name":"Gastroenterology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/renal-cell-carcinoma","display_name":"renal cell carcinoma","score":0.9850000143051147},{"id":"https://openalex.org/keywords/metastatic-renal-cell-carcinoma","display_name":"metastatic renal cell carcinoma","score":0.8700000047683716},{"id":"https://openalex.org/keywords/small-bowel-metastasis","display_name":"small intestine metastasis","score":0.9700000286102295},{"id":"https://openalex.org/keywords/melena","display_name":"melena","score":0.7820000052452087},{"id":"https://openalex.org/keywords/gastrointestinal-bleeding","display_name":"gastrointestinal bleeding","score":0.8870000243186951},{"id":"https://openalex.org/keywords/cabozantinib","display_name":"cabozantinib","score":0.8379999995231628},{"id":"https://openalex.org/keywords/pembrolizumab","display_name":"pembrolizumab","score":0.9750000238418579},{"id":"https://openalex.org/keywords/end-stage-renal-disease","display_name":"end-stage renal disease","score":0.8650000095367432},{"id":"https://openalex.org/keywords/hematochezia","display_name":"hematochezia","score":0.628000020980835},{"id":"https://openalex.org/keywords/anemia","display_name":"anemia","score":0.6050000190734863},{"id":"https://openalex.org/keywords/immunotherapy","display_name":"immunotherapy","score":0.367000013589859},{"id":"https://openalex.org/keywords/hospice-care","display_name":"hospice care","score":0.5040000081062317},{"id":"https://openalex.org/keywords/frontal-lobe-infarction","display_name":"frontal lobe infarction","score":0.5709999799728394}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9570178985595703},{"id":"https://openalex.org/C2777424391","wikidata":"https://www.wikidata.org/wiki/Q1163908","display_name":"Melena","level":2,"score":0.9333962798118591},{"id":"https://openalex.org/C2777601897","wikidata":"https://www.wikidata.org/wiki/Q3409113","display_name":"Presentation (obstetrics)","level":2,"score":0.7146700620651245},{"id":"https://openalex.org/C2777472916","wikidata":"https://www.wikidata.org/wiki/Q1164529","display_name":"Renal cell carcinoma","level":2,"score":0.6942866444587708},{"id":"https://openalex.org/C2777546739","wikidata":"https://www.wikidata.org/wiki/Q33525","display_name":"Carcinoma","level":2,"score":0.5149520039558411},{"id":"https://openalex.org/C61434518","wikidata":"https://www.wikidata.org/wiki/Q932510","display_name":"General surgery","level":1,"score":0.3761490285396576},{"id":"https://openalex.org/C143998085","wikidata":"https://www.wikidata.org/wiki/Q162555","display_name":"Oncology","level":1,"score":0.32186225056648254},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.3152032196521759},{"id":"https://openalex.org/C126838900","wikidata":"https://www.wikidata.org/wiki/Q77604","display_name":"Radiology","level":1,"score":0.18346142768859863}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.14309/01.ajg.0001049100.88142.10","doi":"https://doi.org/10.14309/01.ajg.0001049100.88142.10","is_oa":false,"landing_page_url":"https://doi.org/10.14309/01.ajg.0001049100.88142.10","pdf_url":null,"source":{"id":"https://openalex.org/S66441642","display_name":"The American Journal of Gastroenterology","issn_l":"0002-9270","issn":["0002-9270","1572-0241"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-b","doyens","jufo-2","ki-jl-2","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"American Journal of Gastroenterology","raw_type":"journal-article"}],"best_oa_location":null,"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being","score":1.0}],"study_designs":[],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W4316087393","https://openalex.org/W2980195539","https://openalex.org/W2980277779","https://openalex.org/W2979336643","https://openalex.org/W2972288891","https://openalex.org/W4311287898","https://openalex.org/W2980028591","https://openalex.org/W2977447357","https://openalex.org/W4316078540","https://openalex.org/W4417163663"],"abstract_inverted_index":{"Introduction:":[0],"Renal":[1],"cell":[2],"carcinoma":[3],"(RCC)":[4],"accounts":[5],"for":[6,172,235,317],"approximately":[7],"2%":[8],"of":[9,18,25,31,43,61,80,109,232,269,285,305,312,399,422,426,440,442,449,456],"global":[10],"cancer":[11],"diagnoses":[12],"and":[13,39,90,95,97,146,199,208,254,328,339],"deaths,":[14],"with":[15,45,76,84,105,154,225,271,281,334,376,381],"about":[16],"25%-30%":[17],"patients":[19,44,306,362],"having":[20],"metastatic":[21,46,62,217,403,413],"disease":[22,49,100,371],"at":[23],"time":[24],"diagnosis.":[26],"The":[27,244],"most":[28,374],"common":[29],"sites":[30],"metastases":[32],"(mets)":[33],"include":[34,322],"the":[35,51,65,87,113,165,179,183,188,230,267,400,443,447],"lung,":[36,88],"bone,":[37,89],"liver,":[38],"brain.":[40],"About":[41,303],"0.2%-0.7%":[42],"RCC":[47,63,83,270,276,320],"have":[48,118],"in":[50,178,361,454],"gastrointestinal":[52],"(GI)":[53],"tract.":[54],"Presented":[55],"here":[56],"is":[57,262,387],"a":[58,125,155,226,236,250,263,278,282,364,427,450],"rare":[59],"case":[60,265],"to":[64,86,117,187,228,258,342,358,369],"small":[66,272,345,382,433],"bowel":[67,273,289,346,383,434],"presenting":[68],"as":[69,293],"melena.":[70,110,195],"Case":[71],"Description/Methods:":[72],"A":[73,161],"64-year-old":[74],"man":[75],"prior":[77],"medical":[78],"history":[79,108],"stage":[81,318,377],"IV":[82,319,378],"mets":[85,290,347],"liver":[91],"status":[92],"post":[93],"pembrolizumab":[94,335],"radiotherapy":[96],"end-stage":[98],"renal":[99,457],"on":[101],"HD":[102],"was":[103,115,185,197,202,223,241,247,256,336,348,351],"admitted":[104],"1":[106],"week":[107],"On":[111],"arrival,":[112],"patient":[114,166,184],"found":[116,453],"community":[119],"acquired":[120],"pneumonia.":[121],"Lab":[122],"studies":[123],"showed":[124],"hemoglobin":[126,157],"6.6":[127],"g/dL,":[128],"white":[129],"blood":[130,233],"cells":[131,455],"15.4":[132],"x":[133,137],"103/mL,":[134,138],"Plt":[135],"210":[136],"international":[139],"normalized":[140],"ratio":[141],"1.2,":[142],"Bun":[143],"38":[144],"mg/dL,":[145],"Cr":[147],"7.4":[148],"mg/dL.":[149],"DRE":[150],"revealed":[151,216],"brown":[152],"stool":[153],"stable":[156],"after":[158],"2":[159],"pRBC\u2019s.":[160],"few":[162],"days":[163,177],"later,":[164],"became":[167],"hypotensive":[168],"requiring":[169,363],"ICU":[170],"support":[171],"undifferentiated":[173],"shock.":[174],"After":[175],"3":[176],"intensive":[180],"care":[181],"unit,":[182],"transferred":[186],"general":[189],"medicine":[190],"floors,":[191],"when":[192],"he":[193,255],"developed":[194],"GI":[196],"consulted":[198],"push":[200,406,416],"enteroscopy":[201],"performed":[203],"revealing":[204],"non-obstructing":[205],"distal":[206],"duodenal":[207],"jejunal":[209],"polypoid":[210],"masses":[211],"that":[212],"were":[213],"biopsied.":[214],"Pathology":[215],"RCC.":[218],"At":[219],"this":[220,240,331],"point,":[221],"cabozantinib":[222,343],"started":[224],"goal":[227],"reduce":[229],"amount":[231],"transfusions":[234],"home":[237],"discharge.":[238],"Unfortunately,":[239],"not":[242],"achieved.":[243],"hospital":[245],"course":[246],"complicated":[248],"by":[249],"frontal":[251],"lobe":[252],"infarct":[253],"transitioned":[257],"hospice.":[259],"Discussion:":[260],"This":[261],"unique":[264],"given":[266],"rarity":[268],"mets.":[274],"Metastatic":[275],"portends":[277],"poor":[279],"prognosis,":[280],"5-year":[283],"survival":[284],"<":[286],"20%.":[287],"Small":[288],"can":[291,321],"present":[292],"hematochezia,":[294],"melena,":[295],"anemia,":[296],"fatigue,":[297],"weight":[298],"loss,":[299],"obstruction,":[300],"or":[301],"perforation.":[302],"25-50%":[304],"develop":[307],"recurrence":[308],"within":[309],"5":[310],"years":[311],"primary":[313],"tumor":[314],"resection.":[315],"Treatment":[316],"immunotherapy,":[323],"molecularly":[324],"targeted":[325],"therapy,":[326],"surgery,":[327],"radiotherapy.":[329],"In":[330,373],"patient,":[332],"immunotherapy":[333],"originally":[337],"used,":[338],"subsequently":[340],"changed":[341],"once":[344],"identified.":[349],"Cabozantinib":[350],"used":[352],"because":[353],"it":[354],"has":[355],"been":[356],"shown":[357],"be":[359],"effective":[360],"rapid":[365],"treatment":[366,386],"response":[367],"due":[368],"symptomatic":[370],"burden.":[372],"cases":[375],"RCC,":[379],"especially":[380],"mets,":[384],"palliative":[385],"usually":[388],"provided":[389],"(see":[390],"Figure":[391,418,436],"1).Figure":[392],"1.:":[393],"Figures":[394,408],"A,":[395],"B.":[396],"Second":[397],"portion":[398],"duodenum":[401],"showing":[402,412,446],"mass":[404,414],"from":[405,415],"enteroscopy.":[407,417],"C,":[409],"D.":[410],"Jejunum":[411],"E.":[419],"H&E":[420],"stain":[421,439],"biopsy":[423,441],"consisting":[424],"predominantly":[425],"dysplastic":[428],"cellular":[429,444],"infiltrate":[430,445],"without":[431],"identifiable":[432],"mucosa.":[435],"F.":[437],"PAX-8":[438],"expression":[448],"transcription":[451],"factor":[452],"origin.":[458]},"counts_by_year":[{"year":2025,"cited_by_count":1}],"updated_date":"2026-09-29T14:09:16.559479","created_date":"2024-10-25T00:00:00"}
