Spontaneous Regression Of Metastatic Renal Cancer And Improvement In Imdc Risk Criteria Prior To Cytoreductive Nephrectomy
McGillivray, K., McKenna, R., Oades, G., & Rodger, F. (2023). Spontaneous regression of metastatic renal cancer and improvement in IMDC risk criteria prior to cytoreductive nephrectomy. Urology case reports, 51, 102561. https://doi.org/10.1016/j.eucr.2023.102561
View Original Source →Abstract
A 57-year-old male presented with a 2-month history of a cough, weight loss, chest discomfort and night sweats. He was diagnosed with poor prognosis metastatic Renal Cancer (RCC) according to International Metastatic RCC Database Consortium (IMDC) criteria. We observed spontaneous regression of his metastatic disease and concurrent improvement in his IMDC risk stratification. This changed the initial recommendation of the MDT, and the patient elected to undergo cytoreductive nephrectomy (CRN) with the expectation he would need deferred systemic treatment. He made an uneventful post-operative recovery and at 12 months his follow-up imaging continues to show resolution of his metastatic disease.
Case Details
Disease Location
Kidney, lungs
Personal Characteristics
57-year-old caucasian male. History of gastro-intestinal reflux disorder (gord), well-controlled with a proton pump inhibitor
Clinical Characteristics
Presented with a 2-month history of a cough, weight loss, chest discomfort and night sweats to the respiratory physicians. Subsequent investigations revealed a 6.5cm right renal tumour with clear evidence of multifocal bilateral pulmonary metastases measuring up to 1cm in diameter. CT-guided renal biopsy confirmed the presence of clear cell renal carcinoma (rcc). Baseline blood investigations showed him to be anaemic, and a high platelet count
Remission Characteristics
CT at a 3-month interval showed a significant reduction in the size of his pulmonary metastases and his full blood count normalised
Treatment & Mechanisms
Clinical Treatment
Biopsy