Introduction: Distant metastasis of T1a renal cell carcinoma is rare and whether metastasis is more probable in patients undergoing hemodialysis remains unclear. We report the autopsy case of a patient undergoing hemodialysis with multiple metastases that rapidly progressed from T1a renal cell carcinoma treated with multimodal therapy including nivolumab.
Case presentation: A 70-year-old male who underwent hemodialysis was diagnosed with clear cell carcinoma (pT1a, G2) after nephrectomy. Six months post-surgery, bone and lung metastases appeared and treated with radiotherapy and pazopanib, respectively. Nivolumab was administered as second- and fourth-line treatments for lung metastases. The patient died approximately 60 months after initial diagnosis; however, nivolumab controlled disease progression for 24 months. An autopsy revealed the lung's occupation with clear cell carcinoma tumor tissue.
Conclusion: Nivolumab has potential to control lung metastasis progression. Additionally, rechallenge is possible in patients with renal cell carcinoma undergoing hemodialysis.
Keywords: T1a renal cell carcinoma; autopsy; hemodialysis; metastasis; nivolumab.
© 2024 The Authors. IJU Case Reports published by John Wiley & Sons Australia, Ltd on behalf of Japanese Urological Association.