Recurrent metastatic clear cell renal carcinoma with sarcomatoid dedifferentiation treated with surgery and Cabozantinib
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Johnny Boustany1,2, Maher Abdessater1,2, Charbel El Hachem1,2, Ziad El Khoury1,2, Walid El Khoury1,2 and Raghid El Khoury1,2
1 Notre Dame des Secours University Hospital Center (CHUNDS), Byblos City, Lebanon
2 Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
Keywords: clear cell renal carcinoma; sarcomatoid dedifferentiation; metastasectomy; cabozantinib
Received: December 09, 2019 Accepted: March 14, 2020 Published: May 19, 2020
Renal cell carcinoma with sarcomatoid dedifferentiation is an entity of RCC that has undergone an anaplastic transformation with both a carcinomatous and a sarcomatous component. The standard treatment in metastatic patients is immunotherapy.
The aim of this article is to describe our case of metastatic recurrent RCC with sarcomatoid dedifferentiation in a 59 year old male patient treated with nephrectomy and multiple metastasectomies followed by Cabozantinib.
Consecutive PET-CT scans showed no evidence of recurrence, three years after the last metastasectomy, and the patient is having currently a normal life.
Sarcomatoid dedifferentiation remains a poor prognosis factor in RCC. Surgery for metastases followed by Cabozantinib may be a therapeutic option in metastatic young patients. However, a prospective randomized trial would be the best option to validate this approach.
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