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Spontaneous Regression Of Metastatic Renal Cell Carcinoma After Sars-cov-2 Infection: A Report Of Two Cases

Buchler, T. 2021Kidney cancer

Buchler, T., Fiser, L., Benesova, J., Jirickova, H., & Votrubova, J. (2021). Spontaneous Regression of Metastatic Renal Cell Carcinoma after SARS-CoV-2 Infection: A Report of Two Cases. Current oncology (Toronto, Ont.), 28(5), 3403–3407. https://doi.org/10.3390/curroncol28050294

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Abstract

Spontaneous regression of metastatic renal cell carcinoma (mRCC) is a rare event, often associated with an activation of innate immunity by various triggers. SARS-CoV-2 infection induces a strong inflammatory response in some patients and a cytokine storm is one of the main causes of severe morbidity and mortality associated with the virus. Here, we describe two cases of patients with histologically and radiologically proven mRCC whose treatment was delayed due to COVID-19 and who experienced spontaneous tumour regression following the infection. Both patients reported here had predominantly pulmonary and mediastinal involvement and underwent nephrectomy. The interval between the diagnosis of COVID-19 and the detection of tumour regression was 3 and 4 months, respectively. Although approved vaccines and other measures are clearly the best way to prevent COVID-19-associated morbidity and mortality in cancer patients, we hypothesize that innate immunity activation by the infection can contribute to tumour regression in special circumstances.

Case Details

Disease Location

Kidney

Personal Characteristics

71-year-old male. Medical history of type 2 diabetes and prostatic hyperplasia

Clinical Characteristics

Initially presented with weight loss and exertional dyspnoea. A CT scan revealed marked mediastinal lymphadenopathy and multiple lung nodules as well as a tumour of the right kidney. A cryobiopsy of an intramural bronchial right lung lesion was reported as a metastasis of grade 2 clear cell renal cell carcinoma (rcc). 2 months later, the patient was diagnosed with covid-19. Right nephron-sparing nephrectomy was performed 1 year after initial presentation. And confirmed the diagnosis of clear cell renal cell carcinoma. At his first oncology appointment, he had a urinary catheter for obstruction due to prostatic hyperplasia. His medication at this time included metformin, spironolactone, furosemide, and metoprolol. Laboratory results showed renal impairment

Remission Characteristics

1 year after the first visit, during oncology evaluation, a CT scan showed marked regression of all tumour lesions

Treatment & Mechanisms

Proposed Remission Mechanisms

Strong innate sars-cov-2-induced immune response

Clinical Treatment

Biopsy, nephrectomy