Renal carcinoma metastases

In another series of 79 patients at MDACC and Baylor University Houston with renal carcinoma, metastases to the spine were treated between January 1993 and April 1999 by surgery for disabling pain (88%) and/or neurologic dysfunction (51%). Preoperative embolization was required because of increased vascularity in approximately half of the patients. Radiotherapy was performed in 40 patients prior to surgery and immune- and chemotherapy was administered in 70 patients either pre- or post-operatively. The median postoperative survival was 12.3 months. Significant pain reduction was achieved in 89% (84 of 94 episodes) and neurologic improvement in 36 (65%) of 55 patients (Jackson et al. 2001). 

Renal carcinoma Metastasis to skin MClO Tumorigenic hypertriploid... 

Pan J., Mestas J., Burdick M. D., et al. (2006) Stromal derived factor-1 (SDF-1/ CXCL12) and CXCR4 in renal cell carcinoma metastasis. Mol Cancer. 5, 56. 

Fig. 7.14 Computed tomography of the lung from a patient enrolled in a clinical trial, using transfected, autologous tumor cells in combination with dSLIM. (A) Lung metastasis of renal carcinoma (red circles) before vaccination treatment (B) after vaccination.

Juang, S.H. et al.. Suppression of tumorigenicity and metastasis of human renal carcinoma cells by infection with retroviral vectors harboring the murine inducible nitric oxide synthase geas,Hum. Gene Ther., 9 (6), 845, 1998. 

Fig.8.6a,b. Lateral chest radiograph (a) and computed tomography scan of the chest (b) show smooth pleural thickening (arrows) in a patient with left renal carcinoma and homolateral pleural metastasis... 

Sunitinib (7),10 developed by Sugene/Pfizer, was approved in 2006 for the treatment of renal cell carcinoma (RCC). It is a VEGFR kinase inhibitor that slows down the angiogenesis of tumor endothelial cells, which provide nutrients and help tumor growth and metastasis. Sunitinib also blocks KIT, an oncogenic kinase that causes gastrointestinal stromal cell tumors. It was approved as a second-line anti-GSIT therapy for imatinib-resistant patients. 

Naito, S., von Eschenbach, A. C., Giavazzi, R. and Fidler, 1. J. (1986). Growth and metastasis of tumor cells isolated from a human renal cell carcinoma implanted into different organs of nude mice. Cancer Res. 46, 4109-4115. 

Severe pain resulting from a previously asymptomatic thoracic spine metastasis has been attributed to aldesleukin in a 64-year-old man with metastatic renal cell carcinoma (33). 

Trufflandier N, GUle O, Palnssiere J, Prie L, Pointillart V, Ravaud A. Symptomatic nemological epidnral metastasis with interlenkin-2 therapy in metastatic renal cell carcinoma. Tnmori 2002 88(4) 338 10. 

Metastases to the kidney usually occur as part of a widespread dissemination. Renal involvement is frequently bilateral and in a multinodular fashion. Primary carcinoma sources include lung, melanoma, and contralateral kidney and GI tract.Rarely, metastasis to kidney... 

Bleeding from hypervascular tumors, such as duodenal metastasis of renal cell carcinoma, can be stopped by palliative particulate embolization (Fig. 5.8), although other authors preferred Gelfoam [88,89). 

Administration of Cediranib produced dose-dependent inhibition of tumor growth in a range of histologically distinct human tumor xenografts (lung, colon, breast, prostate, and ovarian) and also decreased primary tumor growth, metastasis, and microvessel density in an orthotopic model of murine renal cell carcinoma (Drevs et al. 2004). 

In our small series, satisfactory results were obtained in 73.5% of the cases based on the reduction of opiate doses. One of the major advantages of the injection of alcohol into bone metastasis is the rapid relief of pain occurring within 24-48 h. Duration of pain relief ranged from 2-9 months. It should be pointed out that none of the patients survived beyond 9 months. In five cases, the alcoholization was not performed because of rich vascular opacification after contrast media injection (renal cell carcinoma and thyroid cancer). 

Fig. 2.10.9a,b. Patient suffering from pain due to an osteolytic metastasis of a renal cell carcinoma within his femur. After osteoplasty pain was significantly reduced... 

Tumors exhibiting preferential spread to the lungs as the only site of metastasis include sarcoma, renal cell cancer, and head and neck cancer. In contrast, tumors such as breast, melanoma, and colorectal carcinoma typically metastasize to multiple organ sites (Davidson et al. 2001). 

Lavrenkov K, Meller 1, Cohen Y (2002) Solitary bone metastasis of renal cell carcinoma treated with limb-sparing surgery followed by radiotherapy. Isr Med Assoc 4 385-386... 

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