CLINICAL CASE OF COMPLEX RADICAL TREATMENT OF METASTATIC PROGRESSION TO RARE SITE OF PRIMARY ORGAN CONFINED...

Area of Science:

• Oncology
• Urology
• Nephrology

Background:

• Chromophobe renal cell carcinoma (chRCC) is a rare kidney cancer subtype.
• Late recurrence and metastasis can occur even after initial treatment.

Purpose of the Study:

• To present a case of stage I chRCC with late multifocal metastasis.
• To discuss the rationale for using adjuvant pembrolizumab in such cases.

Main Methods:

• Laparoscopic partial nephrectomy for initial tumor removal.
• Surgical excision of perirenal adipose tissue for metastatic nodules.
• Adjuvant immunotherapy with pembrolizumab.

Main Results:

• Stage I chRCC initially treated with laparoscopic partial nephrectomy.
• Four years later, multifocal metastatic nodules developed in the perirenal adipose capsule.
• Complete surgical removal of metastatic tissue followed by adjuvant pembrolizumab led to a curative outcome.

Conclusions:

• Metastasis in chRCC can occur years after initial treatment, even without local recurrence.
• Complete surgical resection of metastatic disease combined with adjuvant pembrolizumab may be a viable curative strategy.
• Understanding chRCC's molecular characteristics is crucial for treatment decisions.