Spontaneous Regression Of Metastatic Renal Cell Carcinoma
Urology 20(2): Aug 1982; 177-181
View Original Source →Abstract
The authors report two cases of spontaneous regression of pulmonary metastases from hypernephroma; this is an exceptional event that occurs in 0.8% of metastasized renal carcinomas; spontaneous regression in all cancers as a group occurs in 0.0014% of cases. The theories postulated up till now to explain this phenomenon are unconvincing. The authors suggest the possibility of tumorous emboli: this event, that occurs mainly in those carcinomas with a propensity for extension to veins, such as renal carcinoma, choriocarcinoma, hepatoma and liver metastases, does not necessarily give rise to a metastasis. The evidence that leads to advocate nephrectomy in metastasized renal carcinoma is recalled and discussed.
Case Details
Personal Characteristics
A previously well sixty-four-year-old white man
Clinical Characteristics
Weight loss, upper abdominal discomfort, nausea, right upper quadrant abdominal discomfort, slight discomfort in the right flank, solitary pulmonary nodule in the left hilar area, mass in the lower medial half of the right kidney, multiple pulmonary metastases, renal adenocarcinoma, renal cell carcinoma, hemorrhage into necrotic tumor, well-differentiated adenocarcinoma in many prostatic chips, a2 carcinoma of the prostate, right pulmonary lesion
Remission Characteristics
Six weeks after nephrectomy, no nodules were seen in the lung. The patient gained weight and appeared to thrive after surgery. The hepatic enzymes that had been slightly abnormal reverted to normal postoperatively and remained so. Chest x-ray films done at regular intervals have not demonstrated recurrence of tumor.
Treatment & Mechanisms
Proposed Remission Mechanisms
Not discussed
Clinical Treatment
Nephrectomy, thoracotomy with resection of the left fifth rib, removal of lung nodules, transabdominal right radical nephrectomy, 125i implantation of the prostate with simultaneous bilateral pelvic node dissection, right thoracotomy and total excision of the mass
Additional Notes
The patient was not given medroxyprogesterone (Provera) or any medication nor did he have radiotherapy to any area. The patient also had a prolapse of L5-S1 intervertebral disk requiring a laminectomy and a transurethral resection for what was believed to be benign prostatic hypertrophy causing prostatism.