title: Neoadjuvant sunitinib effectiveness in T4 renal clear cell carcinoma: a case report.
abstract: BACKGROUND
  
  
  
  BACKGROUND
  Sunitinib therapy showed an improvement in survival of patients with metastatic renal cell carcinoma.
  
  
  METHODS
  
  
  
  METHODS
  A 51-year-old man, with Eastern Cooperative Oncology Group Score (ECOG) of 0, presented at our Institute in March 2012 for macrohematuria and urinary retention. A computed tomography (CT) scan of the abdomen showed a right renal lesion. The lesion had a diameter of 15 cm and was developing towards the liver, in the absence of cleavage planes between the liver and kidney. A 12 mm finding, suspected as secondary lesion, was detected at the level of the VII hepatic segment. Neoadjuvant chemotherapy with Sunitinib was proposed.
  
  
  RESULTS
  
  
  
  RESULTS
  The patient underwent a ultrasound-guided biopsy, which confirmed the presence of Clear Cell Carcinoma. The patient began chemotherapy treatment in May 2012 according to the scheme SUNITINIB 50 mg daily for 4 weeks every 6 weeks. After four courses of treatment, according to RECIST criteria for solid tumors, 40% (9 cm vs 15 cm) regression of the primary tumor and 33% (8 mm vs 12 mm) regression of the secondary lesion were observed at a CT scan of the abdomen. In February 2013, Laparoscopic Adrenal-Sparing Radical Nephrectomy was performed. At a follow-up of 3 months, performed with a thorax and abdomen CT scans, there was a complete remission of hepatic secondary lesion and no areas of secondary localization of disease.
  
  
  CONCLUSIONS
  
  
  
  CONCLUSIONS
  This case report showed the effectiveness of neoadjuvant chemotherapy with Sunitinib. The use of this chemotherapy agent can change the approach to the management of cRCC.
authors: 1 Department of Urology, University G. D'annunzio, Chieti - Italy.
authors: Stefano
authors: S
authors: Ricciardulli
authors: Dario
authors: D
authors: Del Biondo
authors: Calogero
authors: C
authors: Cicero
authors: Genesio
authors: G
authors: Leo
authors: Guglielmo
authors: G
authors: Zeccolini
authors: Antonio
authors: A
authors: Celia
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001706:Biopsy; D002292:Carcinoma, Renal Cell / Q000556:secondary / Q000628:therapy*; D006801:Humans; D007211:Indoles / Q000627:therapeutic use*; D007680:Kidney Neoplasms / Q000473:pathology / Q000628:therapy*; D010535:Laparoscopy / Q000379:methods; D008113:Liver Neoplasms / Q000556:secondary / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods; D009367:Neoplasm Staging; D009392:Nephrectomy / Q000379:methods; D011758:Pyrroles / Q000627:therapeutic use*; D000077210:Sunitinib; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D007211:Indoles; D011758:Pyrroles; D000077210:Sunitinib