一例伴有主动脉旁淋巴结转移的乳头状肾细胞癌患者，经乐伐替尼和帕博利珠单抗联合治疗及机器人辅助根治性肾切除术后实现了完全切除。
A case of papillary renal cell carcinoma with para-aortic lymph node metastasis that was completely resectable after treatment with combination therapy comprising lenvatinib and pembrolizumab and robot-assisted radical nephrectomy.
作者信息
Hosoi Takayuki, Yoshioka Shunsuke, Hiraguri Akari, Kirihana Yusuke, Koguchi Tomoyuki, Tamaki Makoto, Irisawa Chiharu
机构信息
Urology Takeda General Hospital Aiduwakamatu Fukushima Japan.
Urology Ohta Nishinouchi Hospital Koriyama Fukushima Japan.
出版信息
IJU Case Rep. 2025 Jan 29;8(2):150-153. doi: 10.1002/iju5.12830. eCollection 2025 Mar.
INTRODUCTION
Combination therapy comprising immune checkpoint inhibitors and molecular targeted therapies can be effective for metastatic non-clear cell renal cell carcinoma. We describe a patient with metastatic papillary renal cell carcinoma that was completely pathologically resectable after combination treatment comprising lenvatinib and pembrolizumab and robot-assisted radical nephrectomy.
CASE PRESENTATION
A 35-year-old man was referred to our department for examination of a renal tumor that was diagnosed as left renal cell carcinoma with lymph node metastasis (cT3aN1M0). Because metastasis affected the renal artery, combination therapy comprising lenvatinib and pembrolizumab was initiated. After 6 months of treatment, the patient underwent robot-assisted radical nephrectomy. The pathological results indicated papillary renal cell carcinoma with no viable cells in the lymph nodes.
CONCLUSION
Combination therapy comprising lenvatinib and pembrolizumab for unresectable papillary renal cell carcinoma may effectively allow radical resection and deferred cytoreductive nephrectomy.
引言
免疫检查点抑制剂与分子靶向疗法的联合治疗对转移性非透明细胞肾细胞癌可能有效。我们描述了一名转移性乳头状肾细胞癌患者，在接受了乐伐替尼和帕博利珠单抗联合治疗以及机器人辅助根治性肾切除术后，实现了完全病理切除。
病例介绍
一名35岁男性因肾肿瘤检查转诊至我科，该肿瘤被诊断为左肾细胞癌伴淋巴结转移（cT3aN1M0）。由于转移累及肾动脉，遂开始使用乐伐替尼和帕博利珠单抗进行联合治疗。治疗6个月后，患者接受了机器人辅助根治性肾切除术。病理结果显示为乳头状肾细胞癌，淋巴结中无存活细胞。
结论
乐伐替尼和帕博利珠单抗联合治疗不可切除的乳头状肾细胞癌可能有效地实现根治性切除并推迟减瘤性肾切除术。
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