Rare Cases of SARS–CoV-2 Infection Inducing Spontaneous Regression of Metastatic Kidney Cancer
Posted: Tuesday, November 23, 2021
Approximately 1% of patients with metastatic renal cell carcinoma experience spontaneous regression, especially those with clear cell histology after their primary tumor was removed. Jana Votrubova, MD, of Thomayer University Hospital, Prague, Czech Republic, and colleagues reportedly identified two rare cases of spontaneous regression of metastatic kidney cancer after SARS–CoV-2 infection, and their case study details were published in Current Oncology.
A 71-year-old man presented with exertional dyspnea and weight loss; he had multiple lung nodules, a tumor in the right kidney, and mediastinal lymphadenopathy confirmed by CT scan. Biopsy of the lung lesion revealed a metastasis of grade 2 clear cell renal cell carcinoma, and the patient was admitted for treatment because of developing signs and symptoms of heart failure. A polymerase chain reaction (PCR) test for SARS–CoV-2 was positive, although he received no treatment besides supportive measures.
Once his condition improved, he underwent nephrectomy to confirm histology and was administered spironolactone, metformin, metoprolol, and furosemide. Aside from renal impairment and an increased neutrophil count, laboratory results were normal. Of note, a CT scan showed regression of all tumor lesions, and no treatment was initiated; a follow-up CT scan revealed substantial partial regression of these lesions.
Another patient, a 58-year-old man who presented with a fever and headache, also tested positive for SARS–CoV-2 via a PCR test. He was administered antibiotics, although a chest x-ray revealed bilateral lung infiltrates. Although prednisone therapy caused these infiltrates to regress, a repeat x-ray showed multiple bilateral, round, dense opacities. The patient lost 10 kg over 8 weeks, and a CT scan revealed multiple lung lesions and a renal mass. He then underwent nephrectomy, which revealed clear cell carcinoma.
The patient was asymptomatic and took no regular medication, although blood tests showed renal insufficiency, increased platelets, anemia, and increased C-reactive protein. Because of his poor prognostic features and sarcomatoid histology, a PET/CT was performed and demonstrated reduction in lung metastases.
Disclosure: The study authors reported no conflicts of interest.