A case of multiple metastatic sarcomatoid renal cell carcinoma with complete response to nivolumab

Cancer Rep (Hoboken). 2021 Aug;4(4):e1356. doi: 10.1002/cnr2.1356. Epub 2021 Mar 3.

Abstract

Background: Sarcomatoid renal cell carcinoma (SRCC) is associated with poor prognosis. Although there is no standard treatment for SRCC, recent studies have reported the effectiveness of immune checkpoint inhibitors.

Case: An 82-year-old Japanese man presented to our hospital with an incidental right renal tumor. Abdominal computed tomography (CT) showed an exophytic tumor in the right kidney with suspected right iliopsoas muscle invasion. Laparoscopic right radical nephrectomy was performed. Histopathological diagnosis revealed a clear cell RCC with a spindle cell carcinoma component. CT performed 3 months after surgery revealed multiple bilateral lung metastases and local recurrence. Although the patient received tyrosine-kinase inhibitors for treating multiple metastases, the lung metastases continued to gradually increase, and peritonitis carcinomatosis was observed. Thus, the patient was intravenously administered nivolumab once every 2 weeks. After nivolumab administration, lung metastases, local recurrence, and peritonitis carcinomatosis gradually reduced. After 20 months of nivolumab treatment, the patient achieved a complete response of multiple metastases on CT.

Conclusion: Nivolumab may be used as a treatment option for sarcomatoid renal cell carcinoma with multiple metastases.

Keywords: complete response; multiple metastases; nivolumab; renal cell carcinoma; sarcomatoid carcinoma.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Carcinoma, Renal Cell / diagnosis
  • Carcinoma, Renal Cell / secondary
  • Carcinoma, Renal Cell / therapy*
  • Chemotherapy, Adjuvant / methods
  • Humans
  • Kidney / pathology
  • Kidney / surgery
  • Kidney Neoplasms / diagnosis
  • Kidney Neoplasms / pathology
  • Kidney Neoplasms / therapy*
  • Lung Neoplasms / diagnosis
  • Lung Neoplasms / secondary
  • Lung Neoplasms / therapy*
  • Male
  • Nephrectomy
  • Nivolumab / therapeutic use*
  • Peritoneal Neoplasms / diagnosis
  • Peritoneal Neoplasms / secondary
  • Peritoneal Neoplasms / therapy*
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Nivolumab