Controversies in the Treatment of Metastatic Kidney Cancer: A Case Report and Review of the Literature.

Background: More than 209,000 patients worldwide are diagnosed with renal cell carcinoma each year, with 6,474 new cases diagnosed in 2012, representing the seventh most common cancer in men and the ninth most common cancer in women. Approximately 75% of renal cancers are diagnosed at over the age of 60, with a plateau reached around 70-75 years, when many patients also have a substantial number of age-associated impairments that need to be considered when planning a treatment. Case presentation: We report the case of a 51-year-old man with a cT4N0 clear cell renal carcinoma that was surgically removed. After four months the patient presented lung, adrenal, and bone metastasis and was treated with sunitinib as first-line treatment. After 16 months the patient had an adrenal progression and everolimus was administered as second-line treatment, and after a pneumonitis the treatment was changed to axitinib. Here we review the available evidence regarding the treatment options for the management of metastatic kidney cancer at each step of the case presentation. Conclusion: Renal cell carcinoma treatment requires a multidisciplinary approach. However, depending on the clinical characteristics of the patient, there are some controversial points in the management of this pathology, so we hope that the scientific data and the clinical trials reviewed in this case report can help to guide physicians to make more rational decisions regarding the management of patients. [ABSTRACT FROM AUTHOR]