A patient with renal cell carcinoma (RCC) developed synchronous bone metastasis with metachronous relapses to the bone and renal fossa. The primary lesion was initially removed surgically, and the metastatic bone lesions and locally recurrent tumours were treated by a high-fractional dose and high-total-dose intensitymodulated radiotherapy (IMRT, 60 Gy at 2.5 Gy per fraction) without significant side effects. All the grossly relapsed tumors underwent complete remission (CR) within a short time after IMRT. To date, CR has been maintained for more than two years. This case study reports the successful treatment of radioresistant RCC using a new scheme that involves a fractionation regimen with a high precision radiotherapy.
Carcinoma, Renal Cell/pathology/*radiotherapy ; Dose Fractionation ; Female ; Humans ; Kidney Neoplasms/pathology/*radiotherapy ; Middle Aged ; Neoplasm Recurrence, Local/pathology/*radiotherapy ; Radiotherapy, Intensity-Modulated

Carcinoma, Medullary ; pathology ; Carcinoma, Renal Cell ; diagnosis ; metabolism ; pathology ; radiotherapy ; surgery ; Diagnosis, Differential ; Humans ; Keratins ; metabolism ; Kidney Neoplasms ; diagnosis ; metabolism ; pathology ; radiotherapy ; surgery ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoplasms, Squamous Cell ; pathology ; Nephrectomy ; Radiotherapy, Adjuvant

Pituitary metastasis from renal cell carcinoma is rare and has never been reported for renal cell carcinoma primarily treated with sorafenib. Herein, we present a case of an advanced clear-cell renal cell carcinoma in which pituitary metastasis progressed but extracerebral metastases showed partial response to sorafenib treatment.
Antineoplastic Agents ; therapeutic use ; Carcinoma, Renal Cell ; drug therapy ; pathology ; Humans ; Kidney Neoplasms ; drug therapy ; pathology ; Male ; Middle Aged ; Niacinamide ; analogs & derivatives ; therapeutic use ; Phenylurea Compounds ; therapeutic use ; Pituitary Neoplasms ; radiotherapy ; secondary ; Radiotherapy, Conformal

Multiple bone metastases are common manifestation of many malignant tumors such as lung cancer, breast cancer, prostate cancer and renal cell carcinoma. Bone metastasis is secondary cancer in the bone, and it can lead to bone pain, fracture, and instability of the weight bearing bones, all of which may profoundly reduce physical activity and life quality. Treatment for bone metastasis is determined by multiple factors including pathology, performance status, involved site, and neurologic status. Treatment strategies for bone metastasis are analgesics, surgery, chemotherapy and radiotherapy. External beam radiotherapy has traditionally been an effective palliative treatment for localized painful bone metastasis. However, in some cases such as multiple bone metastases, especially osteoblastic bone metastasis originated from breast or prostate cancer, the radiopharmaceutical therapy using (89)Sr, (186)Re, (188)Re, (153)Sm and (117m)Sn are also useful treatment option because of administrative simplicity (injection), few side effects, low risk of radiation exposure and high response rate. This article offers a concise explanation of the radiopharmaceutical therapy for multiple bone metastases.
Analgesics ; Breast ; Breast Neoplasms ; Carcinoma, Renal Cell ; Drug Therapy ; Lung Neoplasms ; Motor Activity ; Neoplasm Metastasis* ; Osteoblasts ; Palliative Care ; Pathology ; Prostatic Neoplasms ; Quality of Life ; Radiation Oncology ; Radiopharmaceuticals ; Radiotherapy ; Weight-Bearing