title: Extremely Delayed Multiple Brain Metastases from Renal Cell Carcinoma: Remission Achieved with Total Surgical Removal: Case Report and Literature Review.
abstract: BACKGROUND
  Late brain metastasis from renal cell carcinoma (RCC), which is generally considered as metastasis occurring more than 10 years after nephrectomy, often occurs as a solitary lesion, and total resection is recommended to achieve remission.
  
  
  METHODS
  We describe a rare case of multiple late brain metastases from RCC in a 60-year-old man who presented with 3 brain metastases from RCC 22 years after nephrectomy. Total removal of the 3 lesions achieved remission without adjuvant therapy.
  
  
  CONCLUSIONS
  Total removal of late brain metastasis from RCC, even occurring with multiple lesions, can achieve total remission under specific conditions.
authors.affiliation: Department of Neurosurgery, Showa General Hospital, Kodaira, Tokyo, Japan. Electronic address: fukushima-tky@umin.ac.jp.
authors.forename: Yuta
authors.initials: Y
authors.lastname: Fukushima
authors.affiliation: Department of Neurosurgery, Showa General Hospital, Kodaira, Tokyo, Japan.
authors.forename: Gakushi
authors.initials: G
authors.lastname: Yoshikawa
authors.affiliation: Department of Neurosurgery, Showa General Hospital, Kodaira, Tokyo, Japan.
authors.forename: Megumi
authors.initials: M
authors.lastname: Takasago
authors.affiliation: Department of Pathology, Showa General Hospital, Kodaira, Tokyo, Japan.
authors.forename: Seiichiro
authors.initials: S
authors.lastname: Shimizu
authors.affiliation: Department of Neurosurgery, Showa General Hospital, Kodaira, Tokyo, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Tsutsumi
mesh_terms: D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary* / Q000601:surgery*; D002292:Carcinoma, Renal Cell / Q000473:pathology*; D003131:Combined Modality Therapy; D016208:Databases, Factual / Q000706:statistics & numerical data; D006801:Humans; D019394:Ki-67 Antigen / Q000378:metabolism; D007680:Kidney Neoplasms / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D009364:Neoplasm Recurrence, Local / Q000209:etiology*; D009392:Nephrectomy / Q000009:adverse effects
chemical_list: D019394:Ki-67 Antigen
keywords: Brain metastasis; Late recurrence; Renal cell carcinoma; Surgery