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Published in Renal Cell Carcinoma

Expert Opinion / Cases · December 18, 2014

Solitary Neck Mass in RCC Patient

Heather Greene MSN, FNP, AOCNP

 

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Heather Greene MSN, FNP, AOCNP

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  • Han Choi

    Dec 23, 2014

    Assuming the metastatic mass is completely resected with no evidence of metastatic lesions in imaging studies, no further treatment is necessary at the moment.

  • MURALI POLIYEDATH

    Dec 25, 2014

    as all metastatic workups are negative except the solitary neck metastasis ,wide excision is enough now.role of targeted therapy is questionable,

  • Salah Elmesidy

    Dec 30, 2014

    Just follow up

  • Paul Baumann

    Dec 30, 2014

    As a radiation oncologist, I would recommend a course of post surgery radiation to increase the likelihood of local control.

  • deepak sundriyal

    Jan 01, 2015

    It is beyond doubt that the tumor has relapsed and its a blood borne metastasis. She requires TKI therapy as she does not have poor risk factors.

  • Luis Uribe

    Jan 01, 2015

    Anyway this is a metastasic tumor and probably obtain benefit with Sunitinib or other of the new drugs which  are in trials today like Everolimus  or Axitinib

  • Richard Belgrad

    Jan 08, 2015

    Radiate the left neck.
  • Heather Greene MSN, FNP, AOCNP

    Heather R Greene MSN, FNP, AOCNP

    Mar 24, 2015

    Pathology from left parotidectomy shows clear cell carcinoma consistent with renal primary. Margins clear. One intraparotid lynph node negative for malignancy. She has no evidence of metastatic disease elsewhere. Options include additional VEGF-TKI therapy or observation. We are interested in what other clinicians would do in this situation. Any thoughts?
  • Bradley Somer MD

    Bradley G. Somer MD

    Mar 30, 2015

    This patient has resected stage 4 disease with no other sites of metastases. There are no prospective randomized trials definitively supportive of additional adjuvant therapy. There are retrospective comparative series that address this including this link which we commented on several months ago:
    

    http://www.practiceupdate.com/content/targeted-therapy-after-complete-resection-of-metastatic-lesions-in-mrcc/22570/25/10/1
    

    Although, not prospective, the seemingly much better PFS with early targeted therapy is provocative, although no clear cancer specific survival. However, in this case, in light of her age, good risk features, and 10 year disease free interval prior to this, we would consider just observation.

  • Nov 16, 2024

    Pending Moderator approval.
    Delete

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