Renal Medullary Carcinoma Response to Chemotherapy: a Referral Center Experience in Brazil
A 23 year-old black man with sickle cell trait had a six-month history of right back pain associated with dyspnea and weight loss. An ultrasound revealed a six centimeters renal mass. One month later, he was referred to our service for investigation. Computed tomography (CT) scan showed a renal mass measuring eleven centimeters (cm) associated with pleural effusion and signs of lymphangitic carcinomatosis. He was empirically treated with sunitinib 50 mg per day for one week, until the result of the biopsy. The renal mass biopsy revealed renal medullary carcinoma. Owing to the worsening of the dyspnea and the biopsy results, sunitinib was discontinued and chemotherapy with cisplatin 35 mg per square meter plus gemcitabine 1000 mg per square meter both administered on D1 and D8 on a 21 day cycle was introduced. The patient died just one day after the beginning of the chemotherapy and two weeks after renal biopsy (a brief summary of patients epidemiological characteristics, therapies, response and survival rates are presented in Supplementary Table 1).