Apparent Spontaneous Regression Of Pulmonary Metastases Following Nephrectomy For Adenocarcinoma Of The Kidney
Journal of Urology 85(4): April 1961; 494-496
View Original Source →Abstract
The progress of pulmonary metastases from a clear-cell carcinoma of the kidney, the so-called hypernephroma, can be quite unpredictable. The case is reported of a middle-aged woman who developed carcinoma of the kidney complicated by pulmonary metastases. After nephrectomy, the metastases disappeared spontaneously. The patient remains well and the chest radiograph clear three years later.
Case Details
Personal Characteristics
43-year-old man, history of muscular aches over a years period, passage of dark red colored urine, episode of gross hematuria associated with progressive weight loss
Clinical Characteristics
Firm palpable mass in the left upper quadrant, urine brown with strong guaiac reaction, no red cells seen on microscopic examination, blood urea nitrogen was 12.5 mg%, hemoglobin 14.8 grams, excretory urogram revealed a mass occupying the lower pole of the left kidney, chest x-ray showed multiple rounded infiltrates interpreted as being metastatic nodules throughout both lung fields
Remission Characteristics
The previously noted pulmonary metastases were no longer visible on the chest roentgenogram. Subsequent tomograms of the chest also failed to visualize the previous pulmonary metastases except for one at the apex of the right lung
Treatment & Mechanisms
Proposed Remission Mechanisms
Not discussed
Clinical Treatment
Left nephrectomy
Additional Notes
Pathology report: Specimen consisted of the left kidney which was markedly enlarged and of irregular shape due to the extensive growth of tumor and weighed 500 grams. The kidney was contained within the perinephric capsule which was removed with some difficulty. In the hilum, the renal vein was noted to be filled and distended with greyyellow tumor tissue. The ureter was unremarkable. On section, the bulk of the kidney was replaced by mottled grey-yellow, moderately firm tumor mass which spared only the upper pole. Microscopic examination revealed clear-cell carcinoma of the kidney with invasion of the renal vein. The postoperative course was uneventful. The radiologist held that in the presence of pulmonary metastases, x-ray treatment would be impractical. The patient was discharged and went back to his work, doing well. Two years later he was readmitted to the hospital in mild heart failure