Case 332

Area of Science:

• Oncology
• Medical Imaging
• Pharmacology

Background:

• A 65-year-old male with a history of sarcomatoid renal cell carcinoma and prior nephrectomy presented with recurrent disease.
• Treatment included maximum-dose pazopanib and palliative stereotactic body radiation therapy to the recurrence site.

Observation:

• The patient experienced diarrhea requiring loperamide, along with abdominal pain, one month after initiating pazopanib.
• Laboratory results showed a low serum total protein and elevated alkaline phosphatase.
• Vital signs and white blood cell count remained within normal limits.

Findings:

• Surveillance imaging, performed 7 months after pazopanib initiation and shortly after radiation therapy completion, revealed recurrent disease.
• The imaging was a contrast-enhanced CT of the abdomen and pelvis in the venous phase.

Implications:

• This case highlights the challenges in managing recurrent sarcomatoid renal cell carcinoma.
• Further investigation into treatment efficacy and side effect management in such cases is warranted.
• Understanding treatment response and progression patterns is crucial for optimizing patient care.