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.
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.
Authors: Daniel Y C Heng; Wanling Xie; Meredith M Regan; Mark A Warren; Ali Reza Golshayan; Chakshu Sahi; Bernhard J Eigl; J Dean Ruether; Tina Cheng; Scott North; Peter Venner; Jennifer J Knox; Kim N Chi; Christian Kollmannsberger; David F McDermott; William K Oh; Michael B Atkins; Ronald M Bukowski; Brian I Rini; Toni K Choueiri Journal: J Clin Oncol Date: 2009-10-13 Impact factor: 44.544
Authors: Theo M de Reijke; Joaquim Bellmunt; Hein van Poppel; Sandrine Marreaud; Matti Aapro Journal: Eur J Cancer Date: 2009-01-20 Impact factor: 9.162