A Case of Metastatic Sarcomatoid Renal Cell Carcinoma Which Obtained Long-Term Survival by Multidisciplinary Treatment

We report a case of sarcomatoid renal cell carcinoma which occurred in a 62-year-old woman. Presentation symptom was macroscopic hematuria. Diagnosis was performed by the histological and immunohistochemical study of a tumor biopsy specimen that showed suspicious of sarcomatoid renal cell carcinoma. The patient underwent surgical resection of the tumor including the left kidney and the spleen. Histological and immunohistochemical study of the tumor showed sarcomatoid renal cell carcinoma. The pathological stage was diagnosed to be pT3bN2, and multiple lung metastases were detected. Interferon-alpha was administrated as adjuvant therapy, and the lung metastases were stable. However, multiple bone metastases appeared. External beam radiotherapy for bone metastases was performed. Interferon-alpha was continued during radiotherapy, nevertheless, multiple brain and liver metastases appeared. Oral administration of tyrosine kinase inhibitor axitinib was started as second-line therapy, and the patient was able to be kept in stable state for eleven months. Since the liver metastases were progressed eventually, oral administration of mammalian target of rapamycin inhibitor everolimus was started as third-line therapy. The patient results in 51 months survival after diagnosis and a comparatively good quality of life within that time. A review of the literature reveals metastatic sarcomatoid renal cell carcinoma being very poor prognosis less than 1-year survival in spite of systemic therapy. The patient in our present case surviving in long-term, which is rarely reported in the literature, is worth to be reported.