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Large and rapid local recurrence of clear cell renal cell carcinoma
  1. Alice Thomson1,
  2. Derek Hennessey2,3,
  3. Jeremy Goad1 and
  4. Ned Kinnear1,2,3
  1. 1Dept of Urology, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
  2. 2Dept of Urology, Mercy University Hospital, Cork, Ireland
  3. 3Dept of Urology, Austin Hospital, Heidelberg, Victoria, Australia
  1. Correspondence to Dr Ned Kinnear; ned.kinnear{at}gmail.com

Abstract

After radical nephrectomy, clear cell renal cell carcinoma (ccRCC) recurs locally in <3% of patients. Recurrences typically occur 1-2 years postoperatively and grow at 5–20 mm per year. In contrast, this patient’s recurrence was unexpectedly large and swift. A 71-year-old woman was initially found on workup for recurrent urinary tract infections to have a 12 cm left renal tumour. After negative staging scans, she progressed to left open radical nephrectomy. Histology revealed a stage T2b 12 cm ccRCCwith sarcomatoid differentiation, International Society of Urological Pathology (ISUP) grade 4, with clear margins. Only 3 months later, the patient developed left-sided abdominal pain, and CT scans revealed a 15 cm left retroperitoneal local recurrence, as well as widespread peritoneal tumours. In discussion with her treating team, the patient and her family elected not to undergo biopsy or systemic therapy. The patient was palliated and passed away 8 days after re-presentation.

  • urological cancer
  • end of life decisions (palliative care)
  • urological surgery

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Footnotes

  • Contributors AT and NK conceived and designed the case report, acquired the patient data and drafted the manuscript. NK prepared the figures. DH and JG revised the manuscript. All authors were responsible for final approval, and agree to be accountable for the accuracy of the article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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