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    Case Report: DR Aurore Blésius Institut Gustave Roussy

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    Thalis-ashtonganimidis Qufarlessolenson
    A 48-year-old man presented with a left kidney mass and underwent surgery to remove his left kidney, spleen, and part of his pancreas for clear cell carcinoma. He later developed lung metastases and was started on sunitinib, but experienced a tumor lysis syndrome with fever, hypertension and renal failure after two weeks. After treatment and recovery, he had a partial response for over two years until developing anemia and an abdominal mass, found to be a colon metastasis from the clear cell carcinoma. He underwent surgery to remove the colon metastasis and has since remained in complete remission without restarting sunitinib.

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    Case Report: DR Aurore Blésius Institut Gustave Roussy

    Uploaded by

    Thalis-ashtonganimidis Qufarlessolenson
    25 views14 pages
    A 48-year-old man presented with a left kidney mass and underwent surgery to remove his left kidney, spleen, and part of his pancreas for clear cell carcinoma. He later developed lung metastases and was started on sunitinib, but experienced a tumor lysis syndrome with fever, hypertension and renal failure after two weeks. After treatment and recovery, he had a partial response for over two years until developing anemia and an abdominal mass, found to be a colon metastasis from the clear cell carcinoma. He underwent surgery to remove the colon metastasis and has since remained in complete remission without restarting sunitinib.

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    A 48-year-old man presented with a left kidney mass and underwent surgery to remove his left kidney, spleen, and part of his pancreas for clear cell carcinoma. He later developed lung metastases and was started on sunitinib, but experienced a tumor lysis syndrome with fever, hypertension and renal failure after two weeks. After treatment and recovery, he had a partial response for over two years until developing anemia and an abdominal mass, found to be a colon metastasis from the clear cell carcinoma. He underwent surgery to remove the colon metastasis and has since remained in complete remission without restarting sunitinib.

    Copyright:

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    Download as PDF, TXT or read online from Scribd
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    25 views14 pages

    Case Report: DR Aurore Blésius Institut Gustave Roussy

    Uploaded by

    Thalis-ashtonganimidis Qufarlessolenson
    A 48-year-old man presented with a left kidney mass and underwent surgery to remove his left kidney, spleen, and part of his pancreas for clear cell carcinoma. He later developed lung metastases and was started on sunitinib, but experienced a tumor lysis syndrome with fever, hypertension and renal failure after two weeks. After treatment and recovery, he had a partial response for over two years until developing anemia and an abdominal mass, found to be a colon metastasis from the clear cell carcinoma. He underwent surgery to remove the colon metastasis and has since remained in complete remission without restarting sunitinib.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
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    of 14

    Case report

    Dr Aurore Blsius Institut Gustave Roussy

    Case report

    48 year old man. November 2006: left kidney mass for abdominal pain. Wide surgery by : radical nephrectomy with splenectomy and partial pancreatectomy. Clear cell carcinoma T4N0 grade 3 Resection was complete

    Case report

    March 2007: local relapse with 2 lung mets. PS status : 1. Intermediate risk group (MSKCC classification). April 2007: Sunitinib started at standard dose-> 50mg 4 weeks on/ 2 weeks off.

    Case report

    2 weeks after treatments start : emergency admission for fever , severe hypertension, headache and bradycardia. Biology: hyperkaliemia with renal failure The first assesment by contrast ultra-sound technic described decrease of local relapse with dramatic change in tumor vascularisation.

    Baseline

    After 2 weeks of treatment

    Case report

    Diagnosis: tumor lysis syndrom Sunitinib restarted 2 weeks later at 25mg continuous PR was observed until October 2009. Lung mets have disappeared 30 months of treatment = 30 months of PR !

    Case report

    October 2009: strong and rough anemia (7g/dl) and deterioration of general status. Intracolic mass was observed on coloscopy . CT-scan confirmed presence of abdominal mass developped from colon (suggestive of colon cancer for endoscopist).

    Case report

    Biopsy: metastasis of clear cell carcinoma. Andretrospectively, a tiny intra-colic lesion was present on the CT-scan in March 2009

    Case report

    Patient underwent wide resection of its abdominal tumor with resection of jejunum and left colon (11. 09) , with colostomy . Closing of colostomy in January 2010. Currently patient is still in CR , without restart of Sunitinib since October 2009 (last CT scan: April 2010).

    Comments

    Tumor lysis syndrom can be observed with anti-angiogenic drugs (Michels J et al., Invest
    New Drugs .2009)

    Acute anemia should prompt search for occute bleeding from digestive metastasis CR can be achieved with combination of medical and surgical therapy Whether antiangiogenic drugs should have been restarted remains questionable

    And after this presentation

    It will be so refreshing to drink a beer.

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