Spontaneous Regression Of Liver Metastasis From Renal Carcinoma
Journal of Urology 140(3): Sep 1988; 596-597
View Original Source →Case Details
Personal Characteristics
A 52-year-old white man
Clinical Characteristics
Presented with left loin pain, bouts of sweating and anemia. Investigation revealed a 10-centimeter solid tumor in the upper pole of the left kidney. Tumor extension to the renal vein was obvious. Histology revealed a predominantly clear-cell renal carcinoma with many mitotic figures and evidence of invasion of the renal capsule, perinephric fat and fascia. The adventitia of the renal artery also contained tumor. Right upper quadrant pain developed 2 months postoperatively and investigation revealed abnormal liver enzymes but a normal bilirubin. An abdominal CT scan 4 months postoperatively showed a lesion in the right lobe of the liver suggestive of metastasis.
Remission Characteristics
Before starting the protocol a repeat CT scan was reported as showing no abnormality within the liver. A CT scan 8 months postoperatively showed no abnormality of the liver. The patient was asymptomatic at 9-month follow-up.
Treatment & Mechanisms
Proposed Remission Mechanisms
Not discussed
Clinical Treatment
Left radical nephrectomy and lymph node dissection were performed on november 12, 1986. The patient was considered for an immunological protocol for metastatic renal carcinoma.
Additional Notes
The liver and the right kidney were normal. At operation there was evidence of tumor penetration of Gerotas fascia but no evidence of intra-abdominal metastases. The liver was normal to palpation. Fourteen lymph nodes were negative for tumor (T3bN0M0). A CT guided needle biopsy with a 19.5 gauge EZM biopsy needle contained cells that were similar on conventional stains to cells within the primary tumor. Sections were stained with the peroxidase-antiperoxidase method using antibodies to alpha1 antitrypsin and alphafetoprotein, and appropriate controls. The cells considered malignant on hematoxylin and eosin sections were negative for alpha1 antitrypsin and alphafetoprotein.