Renal cell carcinoma: complete response.

A 63-year-old male, ex-smoker since 2000 underwent left radical nephrectomy in June 2004 after being diagnosed with stage II, pT3bN0M0 clear cell carcinoma. In June 2006, a control CT showed a nodule in the superior lobe, on a peripheral location, and another nodule in the base of the right lung. The patient underwent atypical resections of both nodules, confirming the presence of metastatic disease. In August 2006 the patient started treatment with sunitinib (50 mg/day for 4 weeks, with 2 weeks of rest). A total of nine cycles were administered. Periodic monitoring showed good tolerance, only presenting grade 2 erythrodisesthesia and grade 2 thrombocytopenia. CT studies performed every three cycles showed no evidence of disease recurrence. The last cycle was administered in September 2007 and PET imaging confirmed the absence of recurrence. With the patient s consent, treatment was interrupted and periodic radiological and clinical examinations were performed. The patient remained asymptomatic until March 2008 when a control CT revealed an objective progression of the disease at the left lung and mediastinum level. Treatment with sunitinib was restarted at the same doses, completing a total of three cycles, achieving a complete response. The patient is still under treatment.