Pre- Surgical Therapy with Sunitinib for Adrenal Metastasis from Renal Cell Carcinoma : A Case Report

A 60-year-old woman received a right radical nephrectomy for a right renal cell carcinoma (8.5×5.4 cm), cT2N0M0, in August 2000. The histopathological findings revealed a clear cell carcinoma, pT2, grade 1, INFα, v (−). She was started on interferon α (sumiferon : 300 IU) because of an adrenal metastasis from the renal cell carcinoma in August 2008. However, the tumor gradually enlarged and there was a potential to infiltrate the pancreatic body-tail. Therefore, we began the administration of sunitinib for pre-surgical therapy in June 2010, because she had a good performance status, no metastasis to other organs except for the left adrenal gland, and the passage of eight years from the time of resection of the primary origin tumor. She had a good response to therapy, which shrank the tumor by 40% (partial response). Therefore we performed a left adrenalectomy in June 2011. The histopathological findings revealed a metastatic renal cell carcinoma. We stopped the administration of after the operation sunitinib after the operation. She has since preserved her quality of life without any recurrence for 19 months