Bleeding metastasis of renal cell cancer to anal canal treated with radiation

Renal cell cancer (RCC) has the ability to metastasize to various organs, including the anal canal which is reported to be the rarest location. An 88-year-old male patient who had previously been treated for right RCC subsequently developed distant metastases to the prostate, lungs, and small bowel. Four years following nephrectomy, the patient presented with a bleeding anal mass which was excised and has been proven to be an anal canal metastasis of RCC. Seven months post excision, regrowth occurred. The patient underwent stereotactic ablative body radiotherapy resulting in satisfactory regression during the 2-month follow-up period, without episodes of bleeding. The treatment options for metastatic post-nephrectomy disease should be considered with a multidisciplinary approach in order to achieve satisfactory symptom relief.