Department of Urology, Mackay Memorial Hospital, Taipei, Taiwan.
Department of Medicine, Mackay Medical College, Taipei, Taiwan.
BMC Urol. 2018 Nov 14;18(1):105. doi: 10.1186/s12894-018-0420-x.
The spontaneous regression of metastatic renal cell carcinoma is a rare phenomenon, with an estimated incidence of < 1%. We report a case of post-nephrectomy renal cell carcinoma adrenal metastasis, followed by the spontaneous regression of the metastasis after withdrawal of sunitinib.
The patient was a 55-year-old male with clear cell type renal cell carcinoma who previously underwent a left laparoscopic radical nephrectomy. After 51 months of follow up, a recurrence in the left renal fossa was observed and subsequently excised. Four months after excision, an abdominal Computerized tomography (CT) identified an adrenal metastasis of 1.6 cm. The patient was treated with sunitinib. However, the treatment was discontinued because of gastrointestinal side effects and fatigue. Eleven months after the discontinuation of sunitinib treatment, a progression in the adrenal metastasis growth (5.7 cm) was observed, whereas 16 months after the discontinuation, a regression of the adrenal metastasis growth (3.4 cm) was observed. During subsequent follow-ups, a gradual reduction in the size of the adrenal metastasis (1.8 cm) was observed. After 44 months from the discontinuation of sunitinib treatment, the patient was still alive and followed up in the outpatient department.
Sunitinib is a multi-targeted inhibitor of vascular endothelial growth factor (VEGF) receptors. This compound reduces tumor angiogenesis and has been approved worldwide for the treatment of advanced renal cell carcinoma. To our knowledge, this is the fourth case of the spontaneous regression of metastatic renal cell carcinoma after the discontinuation of sunitinib treatment.
转移性肾细胞癌的自发消退是一种罕见现象，估计发病率<1%。我们报告了一例肾细胞癌肾切除术后肾上腺转移，在停用舒尼替尼后转移自发消退。
患者为 55 岁男性，透明细胞型肾细胞癌，先前接受过左侧腹腔镜根治性肾切除术。随访 51 个月后，发现左肾窝复发并随后切除。切除后 4 个月，腹部计算机断层扫描（CT）发现 1.6cm 的肾上腺转移。患者接受舒尼替尼治疗。然而，由于胃肠道副作用和疲劳，治疗被中断。停用舒尼替尼治疗 11 个月后，观察到肾上腺转移生长（5.7cm）进展，而停用 16 个月后，观察到肾上腺转移生长（3.4cm）消退。随后的随访中，观察到肾上腺转移逐渐缩小（1.8cm）。停用舒尼替尼治疗 44 个月后，患者仍存活，并在门诊随访。
舒尼替尼是一种血管内皮生长因子（VEGF）受体的多靶点抑制剂。该化合物可减少肿瘤血管生成，已在全球范围内批准用于治疗晚期肾细胞癌。据我们所知，这是继停用舒尼替尼治疗后第四个转移性肾细胞癌自发消退的病例。
