Regression of Pulmonary Metastasis Following Nephrectomy for Hypernephroma; Eight-Year Follow-Up

Abstract

Two cases of carcinoma of the kidney have been presented in which spontaneous disappearance of metastatic pulmonary lesions has occurred following nephrectomy. Such a phenomenon is quite rare. The number of cases reported are insufficient to alter the current use of nephrectomy in the presence of widespread metastases for other than palliative therapy.

Case Details

Personal Characteristics

57-year-old white man

Clinical Characteristics

Dull ache in the left flank, severe pain with referral to the left lower quadrant and left testis, voiding of bloody urine containing several fishworm-like clots, metastatic nodules in both lungs, tumor had broken through the capsule and invaded the perirenal fat, renal vein contained tumor tissue, nausea, vomiting and epigastric pain, large, perforating type ulcer on the posterior wall of the stomach, stenosing duodenal ulcer with 80% retention of barium

Remission Characteristics

Marked regression of the metastatic nodules

Treatment & Mechanisms

Proposed Remission Mechanisms

Not discussed

Clinical Treatment

Nephrectomy, partial gastrectomy with hoffmeister posterior gastrojejunostomy

Additional Notes

Biopsy of the pulmonary metastatic nodules was not done. The patient was in excellent physical condition. The patient and his wife, being intelligent people, were told the diagnosis, and they elected nephrectomy, on the premise that he would at least be free of renal pain, even though lung metastasis was present. The patients wife committed suicide, using carbon monoxide from the family automobile. Her suicide was attributed to worry over her husband having cancereven though he was in good health, and working every day.