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Spontaneous Regression Of Metastatic Renal Cell Carcinoma After Cytoreductive Nephrectomy: A Case Report

Muraoka, K. 2020Kidney cancer

Muraoka, K., Nishikawa, Y., & Isoyama, T. (2020). Spontaneous regression of metastatic renal cell carcinoma after cytoreductive nephrectomy: A case report. Urology case reports, 31, 101179. https://doi.org/10.1016/j.eucr.2020.101179

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Abstract

We herein report a case involving a 59-year-old man with right lung and mediastinal lymph node metastases from renal cell carcinoma. After cytoreductive nephrectomy without neoadjuvant therapy, he achieved spontaneous regression. The regression was maintained 3 years after the operation. We immunohistochemically examined the surgical specimens and considered the possible mechanism underlying this phenomenon.

Case Details

Disease Location

Kidney

Personal Characteristics

59-year-old man

Clinical Characteristics

Diagnosed with metastatic renal cell carcinoma (mrcc) following combined pulmonary fibrosis and emphysema. Enhanced computed tomography demonstrated a 17-mm-diameter nodule in the s2 site of the right lung, a 60-mm-diameter mass in a mediastinal lymph node, and a 62-mm-diameter mass in the left kidney. Laboratory tests revealed a mild elevation of the c-reactive protein concentration and a slightly low hemoglobin concentration. The patient underwent laparoscopic cytoreductive nephrectomy. The final pathological diagnosis of the renal tumor was clear cell rcc,

Remission Characteristics

One month following surgery, a thoracic computed tomography scan revealed spontaneous regression of the pulmonary nodule and mediastinal lymph node, and both continued to decrease in size for 4 months.

Treatment & Mechanisms

Proposed Remission Mechanisms

Patients with spontaneous regression have already acquired antitumor immunity, and removal of the primary tumor enhances the biological defense system by reduction of the cancer antigen load.

Clinical Treatment

Laparoscopic cytoreductive nephrectomy