Okazaki A, Kijima T, Schiller P, Ishikawa N, Fuchizawa H, Takei K, Suzuki I, Sakamoto K, Tsuzuki T, Kamai T. Spontaneous regression of multiple pulmonary metastases accompanied by normalization of serum immune markers following cytoreductive nephrectomy in a patient with clear-cell renal cell carcinoma.
IJU Case Rep 2021;
4:95-99. [PMID:
33718815 PMCID:
PMC7924083 DOI:
10.1002/iju5.12252]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 11/30/2020] [Accepted: 12/05/2020] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION
The spontaneous regression of metastases, which mostly occurs after surgical resection of the primary tumor, has been described in various malignancies, including renal cell carcinoma. The involvement of the host immune system is currently postulated as the underlying mechanism.
CASE PRESENTATION
We present a case of metastatic clear-cell renal cell carcinoma that achieved complete spontaneous regression of multiple pulmonary metastases preceded by normalization of serum immune markers after cytoreductive nephrectomy. The patient remained disease free for 3 years without any systemic therapy, suggesting that postoperative normalization of serum immune markers may indicate recovery of the host immune system, which prevents tumor recurrence.
CONCLUSION
Monitoring of serum immune markers may be useful to identify patients with recovered immune function and, therefore, may not require systemic therapy. Similarly, the case suggests a potential role of cytoreductive nephrectomy in the contemporary management of metastatic renal cell carcinoma.
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