Neoadjuvant Temsirolimus Effectiveness in Downstaging Advanced NonClear Cell Renal Cell Carcinoma

Volume 58, issue 2, pages e19-e28, August 2010

Oscar Rodríguez Faba, Alberto Breda, Antonio Rosales, Joan Palou, Ferran Algaba, Pablo Maroto Rey and Humberto Villavicencio

Accepted 3 March 2010, Published online 12 March 2010, pages 307 - 310

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Fig. 1 Pretreatment computed tomography scan: Right side: 12-cm tumour. Retroperitoneal lymph node involvement.

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Furthermore, massive retroperitoneal lymphadenopathy was present (Fig. 1).
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Fig. 2 Renal biopsy. Unclassified non–clear cell renal cell carcinoma with eosinophilic cells Fuhrman grade III.

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Due to the extent of the disease, a renal mass biopsy was obtained that revealed an eosinophilic unclassified non–clear cell renal cell carcinoma (RCC) (Fig. 2).
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Fig. 3 Downstaging of renal mass and lymph nodes after 6 wk of temsirolimus.

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A CT scan was performed at 6 wk that showed a significant downstaging of the tumor and retroperitoneal lymph nodes (Fig. 3).
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Fig. 4 Intraoperative images showing the kidney, inferior vena cava, and lymphadenopathy.

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Due to this success, it was possible 3 mo later to perform a laparoscopic radical nephrectomy with retroperitoneal lymphadenectomy (Fig. 4).
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Fig. 5 Final pathology. Unclassified non–clear cell renal cell carcinoma with eosinophilic cells Fuhrman grade III.

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The surgery was uneventful, and the final pathology confirmed eosinophilic non–clear cell RCC Fuhrman grade III, with fibrotic and necrotic changes on lymph nodes specimens, pT1bN0Mx (Fig. 5).
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PII: S0302-2838(10)00223-X
DOI: 10.1016/j.eururo.2010.03.005
© 2010 European Association of Urology, Published by Elsevier B.V.

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