Abstract
A 72-year-old man presenting with a 14-cm left renal mass, an inferior vena cava (IVC) tumor thrombus, and pulmonary metastases underwent renal mass biopsy that revealed clear cell renal cell carcinoma. Because of metastases and the extent of the tumor thrombus, sunitinib was administered, which resulted in a marked reduction in the tumor thrombus (from level III to level II after 11 weeks of treatment). Ultrasonography, preceding computed tomography, showed a slight shrinkage of the tumor thrombus level in the first 2 weeks. Therefore, ultrasound may be advantageous to monitor the IVC tumor thrombus level during the early phase of targeted therapy.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Abbreviations
- IVC:
-
Inferior vena cava
- MTT:
-
Molecular targeted therapy
- US:
-
Ultrasonography
References
Pouliot F, Shuch B, Larochelle JC, et al. Contemporary management of renal tumors with venous tumor thrombus. J Urol. 2010;184:833–41.
Neves RJ, Zincke H. Surgical treatment of renal cancer with vena cava extension. Br J Urol. 1987;59:390–5.
Motzer RJ, Bacik J, Murphy BA, et al. Interferon-alpha as a comparative treatment for clinical trials of new therapies against advanced renal cell carcinoma. J Clin Oncol. 2002;20:289–96.
Bex A, Blank C, Meinhardt W, et al. A phase II study of presurgical sunitinib in patients with metastatic clear-cell renal carcinoma and the primary tumor in situ. Urology. 2011;78:832–7.
Karakiewicz PI, Suardi N, Jeldres C, et al. Neoadjuvant sutent induction therapy may effectively down-stage renal cell carcinoma atrial thrombi. Eur Urol. 2008;53:845–8.
Sano F, Makiyama K, Tatenuma T, et al. Presurgical downstaging of vena caval tumor thrombus in advanced clear cell renal cell carcinoma using temsirolimus. Int J Urol. 2012 (Epub ahead of print).
Cost NG, Delacroix SE Jr, Sleeper JP, et al. The impact of targeted molecular therapies on the level of renal cell carcinoma vena caval tumor thrombus. Eur Urol. 2011;59:912–8.
Bex A, Van der Veldt AA, Blank C, et al. Progression of a caval vein thrombus in two patients with primary renal cell carcinoma on pretreatment with sunitinib. Acta Oncol. 2010;49:520–3.
ClinicalTrials.gov (homepage on the internet). Clinical trial to assess the importance of nephrectomy (CARMENA). 2012. http://www.clinicaltrial.gov/ct2/show/NCT00930033. Accessed 16 November 2012.
Flanigan RC, Mickisch G, Sylvester R, et al. Cytoreductive nephrectomy in patients with metastatic renal cancer: a combined analysis. J Urol. 2004;171:1071–6.
Lawrentschuk N, Gani J, Riordan R, et al. Multidetector computed tomography vs magnetic resonance imaging for defining the upper limit of tumour thrombus in renal cell carcinoma: a study and review. BJU Int. 2005;96:291–5.
Guo HF, Song Y, Na YQ. Value of abdominal ultrasound scan, CT and MRI for diagnosing inferior vena cava tumour thrombus in renal cell carcinoma. Chin Med J. 2009;122:2299–302.
Abel EJ, Culp SH, Tannir NM, et al. Primary tumor response to targeted agents in patients with metastatic renal cell carcinoma. Eur Urol. 2011;59:10–5.
Conflict of interest
None declared.
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Sano, F., Fusayasu, S., Otake, S. et al. Early ultrasonographic evaluation of tumor thrombus level during sunitinib therapy for renal cell carcinoma. J Med Ultrasonics 40, 463–465 (2013). https://doi.org/10.1007/s10396-013-0448-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10396-013-0448-1