Metastatic Renal Cell Carcinoma Presenting as a Solitary Gastric Polyp

A 77-year-old Caucasian man with a remote history of renal cell carcinoma status post nephrectomy 20 years ago underwent an esophagogastroduodenoscopy for persistent dyspepsia. The esophagogastroduodenoscopy showed a 10-mm friable pedunculated polyp in the gastric body (Figure A). Histopathology of the gastric polyp showed ulcerated mucosa containing large atypical cells with increased mitotic activity and abundant eosinophilic cytoplasm in the lamina propria (Figure B). These cells were positive for PAX8 (Figure C), with focal reactivity with CAM5.2 (Figure D) and OSCAR cytokeratin, consistent with metastatic renal cell carcinoma of the stomach.

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