Renal Medullary Carcinoma of the Left Kidney With Metastatic Disease to the Lungs

Bradley G. Somer MD

Aug 02, 2016

This is a fairly typical presentation of this relatively rare disease. A young African American with either Sickle cell disease or Sickle trait presenting with widespread metastases at the time of diagnoses is nearly a universal story with this Renal Medullary Carcinoma (RMC). In this case, the finding of RMC enabled him to find a sickle cell trait- unbeknownst to him. It is usually an aggressive and advanced at diagnoses and historical survival is very poor. Platinum based chemotherapy is the standard, not because it works well, but because in some series, patients receiving chemotherapy seemed to do best and there are more limited signals that targeted therapies has much efficacy. This young man is fortunate to have had a good response and hopefully it is durable, but certainly historical data suggests this could be short lived. In that case there is clearly no standard and he is strongly recommended to go on a trial. Off of a trial it is reasonable to consider immunotherapy, however, the data is more limited.