title: Preoperative induction with sorafenib pathologically downstaged advanced renal cell carcinoma: a case report.
abstract: We present the case of a patient with renal cell carcinoma treated preoperatively with sorafenib. Complete resection of the left renal mass measuring 7.2 x 6.6 cm seemed to be difficult at diagnosis because of large renal hilar lymph nodes. With a short period of sorafenib administration, marked shrinkage of the renal mass and lymphadenopathy was observed after the patient experienced fulminant hepatic failure and a severe hand-foot skin reaction. Two-dimensional computed tomography revealed 60%, 78% and 84% reduction in the primary renal tumor, lung metastatic nodules and lymph nodes, respectively. Tumor shrinkage allowed for complete resection of the left kidney and the lymphadenopathy. Pathological findings revealed that over 90% of the renal tumor was substituted by necrotic fibrotic tissue and that the residual neoplastic component was diagnosed as clear cell carcinoma. The lymph nodes that were resected were negative for malignancy. At 6 months after radical nephrectomy, a new computed tomography scan revealed no evidence of disease with the disappearance of lung nodules.
authors.affiliation: Department of Urology, Ikeda Municipal Hospital, Ikeda, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Kinoshita
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Inoue
authors.forename: Toshiro
authors.initials: T
authors.lastname: Kinouchi
authors.forename: Masao
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Takada
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Hara
authors.forename: Koji
authors.initials: K
authors.lastname: Hatano
authors.forename: Norio
authors.initials: N
authors.lastname: Nonomura
mesh_terms: D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D001557:Benzenesulfonates / Q000008:administration & dosage*; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery*; D009392:Nephrectomy; D009536:Niacinamide / Q000031:analogs & derivatives; D010671:Phenylurea Compounds; D011300:Preoperative Care; D011725:Pyridines / Q000008:administration & dosage*; D012720:Severity of Illness Index; D000077157:Sorafenib; D014057:Tomography, X-Ray Computed
chemical_list: D000970:Antineoplastic Agents; D001557:Benzenesulfonates; D010671:Phenylurea Compounds; D011725:Pyridines; D009536:Niacinamide; D000077157:Sorafenib