A unique presentation of renal cell carcinoma: both upper and lower gastrointestinal bleeding.

Renal cell carcinoma (RCC) constitutes 3% of all adult malignancies and may present with various symptoms due to local growth, metastasis, and paraneoplastic syndrome. Gastrointestinal hemorrhage because of RCC is a very rare event and more commonly seen as a recurrence of RCC many years after nephrectomy. Both upper and lower gastrointestinal bleeding due to direct invasion of RCC has not been reported yet in the literature. Herein, we report a case of 78-year-old man with both massive upper and lower gastrointestinal bleeding as a presenting symptom of RCC.