title: Presurgical downstaging of vena caval tumor thrombus in advanced clear cell renal cell carcinoma using temsirolimus.
abstract: A 63-year-old man presenting with a 7.2-cm right renal mass, an inferior vena cava tumor thrombus, and pulmonary metastases underwent renal mass biopsy that revealed clear cell renal cell carcinoma. Temsirolimus (25 mg weekly) was given because of the extent of the disease and poor performance status, which resulted in a marked reduction in the tumor thrombus (from level III to level I) after 20 weeks of treatment. Subsequently, radical nephrectomy and tumor thrombectomy were carried out. Final pathological analysis confirmed the diagnosis of high-grade clear cell carcinoma (pT4N0M1). One year after initiation of temsirolimus therapy, the patient remained alive despite the presence of disease.
authors.affiliation: Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan. fsano@yokohama-cu.ac.jp
authors.forename: Futoshi
authors.initials: F
authors.lastname: Sano
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Makiyama
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Tatenuma
authors.forename: Ryoko
authors.initials: R
authors.lastname: Sakata
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yamanaka
authors.forename: Syusei
authors.initials: S
authors.lastname: Fusayasu
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakayama
authors.forename: Noboru
authors.initials: N
authors.lastname: Nakaigawa
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yao
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Kubota
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000188:drug therapy* / Q000473:pathology; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D020123:Sirolimus / Q000031:analogs & derivatives* / Q000627:therapeutic use; D013927:Thrombosis / Q000209:etiology* / Q000473:pathology; D014682:Vena Cava, Inferior / Q000473:pathology*
chemical_list: D000970:Antineoplastic Agents; C401859:temsirolimus; D020123:Sirolimus