Department of Urology, Gifu University Graduate School of Medicine, Gifu, Japan.
Department of Urology, Japanese Red Cross Takayama Hospital, Takayama, Japan.
Cancer Rep (Hoboken). 2021 Aug;4(4):e1356. doi: 10.1002/cnr2.1356. Epub 2021 Mar 3.
Sarcomatoid renal cell carcinoma (SRCC) is associated with poor prognosis. Although there is no standard treatment for SRCC, recent studies have reported the effectiveness of immune checkpoint inhibitors.
An 82-year-old Japanese man presented to our hospital with an incidental right renal tumor. Abdominal computed tomography (CT) showed an exophytic tumor in the right kidney with suspected right iliopsoas muscle invasion. Laparoscopic right radical nephrectomy was performed. Histopathological diagnosis revealed a clear cell RCC with a spindle cell carcinoma component. CT performed 3 months after surgery revealed multiple bilateral lung metastases and local recurrence. Although the patient received tyrosine-kinase inhibitors for treating multiple metastases, the lung metastases continued to gradually increase, and peritonitis carcinomatosis was observed. Thus, the patient was intravenously administered nivolumab once every 2 weeks. After nivolumab administration, lung metastases, local recurrence, and peritonitis carcinomatosis gradually reduced. After 20 months of nivolumab treatment, the patient achieved a complete response of multiple metastases on CT.
Nivolumab may be used as a treatment option for sarcomatoid renal cell carcinoma with multiple metastases.
肉瘤样肾细胞癌（SRCC）与预后不良相关。尽管 SRCC 尚无标准治疗方法，但最近的研究报告了免疫检查点抑制剂的有效性。
一位 82 岁的日本男性因偶然发现的右肾肿瘤就诊于我院。腹部计算机断层扫描（CT）显示右肾外生性肿瘤，疑似右侧髂腰肌侵犯。行腹腔镜右肾根治性切除术。组织病理学诊断为透明细胞肾细胞癌伴梭形细胞癌成分。术后 3 个月行 CT 检查显示双侧肺多发转移和局部复发。尽管该患者接受酪氨酸激酶抑制剂治疗多发转移，但肺转移仍逐渐增加，并出现癌性腹膜炎。因此，该患者每 2 周静脉注射纳武利尤单抗一次。纳武利尤单抗给药后，肺部转移灶、局部复发和癌性腹膜炎逐渐减少。纳武利尤单抗治疗 20 个月后，患者 CT 显示多发转移完全缓解。
纳武利尤单抗可能是治疗多发转移肉瘤样肾细胞癌的一种治疗选择。
