Date of Presentation

5-2-2019 12:00 AM

College

School of Osteopathic Medicine

Poster Abstract

This is a case of a 73-year-old Caucasian male presenting with an asymptomatic right adrenal mass.

Renal Cell Carcinoma (RCC) constitutes 80 to 85% of primary renal neoplasms. At presentation, up to 25% of patients with RCC will have evidence of metastases or locally advanced disease. [1] Patients will rarely present with any symptoms since the majority of patients are incidentally diagnosed due to radiologic procedures performed for other indications. RCC is considered the most lethal of urologic cancers because a patient without intervention who has stage IV metastatic disease has a 5-year survival rate of 23% in comparison to 96% for stage I disease.[14]

RCC has several treatment options. The standard of care for localized RCC is surgical resection. Since our patient has metastatic disease, adjuvant therapy is the ideal treatment method. This includes surgical resection prior to chemotherapy or immunotherapy. Current focus is on therapeutics that target vascular endothelial growth factor receptor (VEGF-R) and mammalian target of rapamycin (mTOR). [15] Since this patient presented with a solitary metastatic RCC lesion, the treatment of choice is surgical resection if feasible. With adrenalectomy(solitary metastatic lesion), the patient’s 5-year survival rate at is estimated to be 51%, whereas the 5-year survival rate with adjuvant targeted therapy is estimated to be 18%. [16] Current research indicates that there is no improvement in survival outcome with adjuvant therapy after resection of a solitary metastatic RCC lesion. [15]

Keywords

renal cell carcinoma, adrenal mass, urologic cancer

Disciplines

Medicine and Health Sciences | Neoplasms | Oncology | Urology

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May 2nd, 12:00 AM

Recurrent Renal Cell Carcinoma Post Radical Nephrectomy: A Case Report

This is a case of a 73-year-old Caucasian male presenting with an asymptomatic right adrenal mass.

Renal Cell Carcinoma (RCC) constitutes 80 to 85% of primary renal neoplasms. At presentation, up to 25% of patients with RCC will have evidence of metastases or locally advanced disease. [1] Patients will rarely present with any symptoms since the majority of patients are incidentally diagnosed due to radiologic procedures performed for other indications. RCC is considered the most lethal of urologic cancers because a patient without intervention who has stage IV metastatic disease has a 5-year survival rate of 23% in comparison to 96% for stage I disease.[14]

RCC has several treatment options. The standard of care for localized RCC is surgical resection. Since our patient has metastatic disease, adjuvant therapy is the ideal treatment method. This includes surgical resection prior to chemotherapy or immunotherapy. Current focus is on therapeutics that target vascular endothelial growth factor receptor (VEGF-R) and mammalian target of rapamycin (mTOR). [15] Since this patient presented with a solitary metastatic RCC lesion, the treatment of choice is surgical resection if feasible. With adrenalectomy(solitary metastatic lesion), the patient’s 5-year survival rate at is estimated to be 51%, whereas the 5-year survival rate with adjuvant targeted therapy is estimated to be 18%. [16] Current research indicates that there is no improvement in survival outcome with adjuvant therapy after resection of a solitary metastatic RCC lesion. [15]

 

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