Regression of metastatic renal cell carcinoma following nephrectomy

Abstract

Regression of pulmonary metastases following nephrectomy for renal cell carcinoma has occurred in two patients. In one patient, a hepatopathy also disappeared, and the patient remained free from disease for 16 years. In the other patient, following nephrectomy there was disappearance of hypercalcemia, presumably due to removal of a source of production of a parahormone‐like polypeptide. It appears that older males with only pulmonary metastases make up the majority of patients in whom regression of metastases after nephrectomy has been observed. Hormonal and immunologic factors are implicated in this phenomenon. There is a sound rationale for nephrectomy in the presence of metastatic renal cell carcinoma.

Metastatic renal cell carcinoma (RCC): Spontaneous regression, long-term survival and late recurrence

“…Therefore most authors are in favour of nephrectomy [11,13,18,19], especially if there is only a single metastasis [7,17,18]. Garfield [13] defines the role of adjunctive nephrectomy in patients with metastatic renal cell carcinoma as follows:…”

“…Garfield [13] defines the role of adjunctive nephrectomy in patients with metastatic renal cell carcinoma as follows:…”

“…interferons), with which the rate of spontaneous remissions can reach more than 20%. Interesting in this context is that there seems to be an organ specificity in the ability to cope with metastases [13,16]. Out of 39 reported cases 37 represented regression of pulmonary metastases, and in some instances there was simultaneous regression of pulmonary metastases with progression of nonpulmonary metastases, e.g.…”

“…Out of 39 reported cases 37 represented regression of pulmonary metastases, and in some instances there was simultaneous regression of pulmonary metastases with progression of nonpulmonary metastases, e.g. in the bones or brain [13]. An explanation may be that pulmonary tissue, probably caused by constant exposure to foreign antigens, is especially rich in macrophages, lymphocytes and immunoglobulin lgA (immunological hypothesis) [16].…”

Metastatic renal cell carcinoma to the thyroid gland presenting 17 years after nephrectomy

“…Radiographic differences cannot be used to discriminate between a primary or metastatic thyroid tumour as both of these lesions will appear as 'cold' nodules on radioiodine uptake studies or as a 'hypoechoic' mass on ultrasound. 17,18 The true metastatic nature of the tumour is recognized only after tumour sampling with pathological assessment.…”