PMC10380977_01
(A) Initial contrast-enhanced CT. A horseshoe kidney with a bulky tumor affecting a large part of the right kidney, a coronal plane. (B) An axial plane. (C) Follow-up contrast enhanced CT. Partial regression of the tumor after, 2 month from therapy initiation, a coronal plane. (D) An axial plane. (E) Follow-up contrast enhanced CT. Partial regression of the tumor, 5 months from therapy initiation, a coronal plane. (F) An axial plane. (G) Follow-up contrast enhanced CT. Complete radiographic regression of the tumor, a coronal plane. (H) An axial plane.
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The dimensions of the tumor were 150x120x100 mm ( Figures 1A, B ). Solid Tumors (RECIST) 1.1 was achieved ( Figures 1C, D ). Since the surgical intervention was not feasible yet, it was decided to continue with systemic treatment for additional 3 months. The most marked effect of the therapy was noticed at the start of the treatment, with only mild reduction of the tumor in the last 3 months ( Figures 1E, F ). In September 2022, a follow up CT scan confirmed complete radiographic remission, and no further systemic therapy was offered after the operation ( Figures 1G, H ).
Histological examination. (A) A regressively changed clear cell renal cell carcinoma. (B) A regressively changed clear cell renal cell carcinoma in detail. (C) A regressively changed clear cell renal cell carcinoma, hyalinosis and stromal edema.
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Final histological analysis showed regressively changed (ccRCC) ( Figures 2A-C ), pathologic TNM classification was pT2a with negative margins evaluated as a major partial response.
A timeline showing relevant data from the patient case report.
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All relevant data are depicted in a timeline ( Figure 3 ).