Recurrent renal cell cancer: 10 years or more after nephrectomy

Abstract

Localized renal cell carcinoma (RCC) responds well to surgery. Patients often question how long they have to be on surveillance after their surgery. Several follow-up patterns have been described in the literature. Until 2009, no published established Canadian guidelines existed to assist Canadian health-care practitioners in the surveillance of these patients. We present 3 cases of RCC that recurred 10 years or longer after the initial nephrectomy. These cases emphasize the need for careful long-term follow-up, as recommended in the Canadian Urological Association guidelines. We also discuss the optimism of prolonged disease survival in the era of novel therapeutic agents that target angiogenesis.

Fig. 1a.

For case 1, in 1993, solid Fuhrman grade I (image A), cystic area (image B).

Fig. 1b.

For case 1, in 2006, clear cell renal cell carcinoma, 10x magnification (image A), area with cystic architecture (image B).

Fig. 2a.

For case 2, clear cell renal cell carcinoma, Fuhrman grade I at 10x magnification.

Fig. 2b.

For case 2, clear cell renal cell carcinoma with renal vein involvement.

Fig 2c.

For case 2, areas with high-grade features, Fuhrman grade III–IV.

Fig. 3.

A: Tumour in right renal fossa; B: tumour in the pancreatic bed; C: tumour in the solitary left kidney; D: urinary bladder retention.