Regression of Metastatic Renal Cell Carcinoma Following Nephrectomy

Abstract

Herein we review 48 acceptable cases of idiopathic regression of metastases from renal cell carcinoma culled from the literature and present 3 additional cases. The data are analyzed and the issue of organ specificity in coping with metastases is discussed.

Case Details

Personal Characteristics

A 61-year-old caucasian man with a 7-month history of vague abdominal discomfort, anorexia, constipation, and a 40-pound weight loss

Clinical Characteristics

The lungs were clear, and no abdominal masses were palpable. The hemoglobin was 12 gm/100 ml, and the white blood cell count was 6,900/mm3 with a normal differential. The platelets were 546,000/mm3, and the sedimentation rate was 82 mm/hour. The urinalysis revealed a specific gravity of 1.015, ph 6; no protein was detected, and the sediment had no cells. Bun was normal. The serum calcium was 11.8 mg/100 ml, and the serum phosphorus was 3.0 mg/100 ml. Liver function studies were normal. The serum albumin was 2.5 mg/100 ml, alpha1 globulin 0.6 gm/100 ml, alpha2 globulin 1.0 gm/100 ml, and gamma globulin 1.3 gm/100 ml. The chest x-ray showed multiple bilateral pulmonary nodules.

Remission Characteristics

Eleven weeks after surgery, he was still feeling well. The chest x-ray showed a decrease in the size of all the pulmonary nodules. By the 18th week, the chest x-ray showed disappearance of all pulmonary lesions.

Treatment & Mechanisms

Proposed Remission Mechanisms

Hormonal and immunologic factors

Clinical Treatment

A surgical exploration with a palliative right nephrectomy was performed on december 16, 1970. A renal tumor which was superficially invading the right lobe of the liver was dissected from the liver and diaphragm. The kidney and tumor appeared to be completely removed.

Additional Notes

The patient has returned full time to his occupation as a grave digger.