Partial Nephrectomy as Management of Oligometastatic Cancer with Limited Systemic Treatment Options A Case Report
Main Article Content
Keywords
Kidney cancer, metastases, brachytherapy, ocular melanoma, melanoma
Abstract
Ocular melanoma is a form of melanoma that rarely offers actionable mutations for treatment with systemic therapy and is relatively radioresis-tant. As such, surgery is the mainstay of treatment for localized disease and can be considered for oligometastatic disease. We present a case of ocular melanoma that recurred with a solitary renal metastasis 9 years after initial diagnosis and treatment with intraocular brachytherapy. After multidisciplinary discussion, the patient underwent a partial nephrectomy for her solitary renal metastasis. The patient continued in follow-up 3.5 years after partial nephrectomy. She was treated again surgically for a solitary metastasis to the breast before initiation of systemic therapy once multifocal disease was identified. We suggest interdisciplinary management of patients with metastatic involvement of target organs, given the rapidly changing treatment landscape for melanoma and other forms of cancer.
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27. Campbell SC, Clark PE, Chang SS, Karam JA, Souter L, Uzzo RG. Renal mass and localized renal cancer: Evaluation, management, and follow-up: AUA guideline: Part I. J Urol. 2021;206(2):199–208. https://doi.org/10.1097/JU.0000000000001911
28. Abrams HL, Spiro R, Goldstein N. Metastases in carcinoma; analysis of 1000 autopsied cases. Cancer. 1950;3(1):74–85. https://doi.org/10.1002/1097-0142(1950)3:1<74::aid-cncr2820030111>3.0.co;2-7
29. Hauser N, Giakas J, Robinson H, Davaro F, Hamilton Z. Utilization of partial cytoreductive nephrectomy in patients with metastatic renal cell carcinoma. J Clin Med. 2024;13(19):5767. https://doi.org/10.3390/jcm13195767
2. Shain AH, Yeh I, Kovalyshyn I, Sriharan A, Talevich E, Gagnon A, et al. The genetic evolution of melanoma from precursor lesions. N Engl J Med. 2015;373(20):1926–36. https://doi.org/10.1056/NEJMoa1502583
3. Sundararajan S, Thida AM, Yadlapati S, Mukkamalla SKR, Koya S. Metastatic melanoma. In StatPearls. 2024.
4. Perdona S, Di Trolio R, Di Lorenzo G, Autorino R. A case of renal melanoma metastasis: Description of clinico-pathological features. Arch Ital Urol Androl. 2007;79(4):161–163.
5. Shimko MS, Jacobs SC, Phelan MW. Renal metastasis of malignant melanoma with unknown primary. Urology. 2007;69(2):384.e9–10. https://doi.org/10.1016/j.urology.2006.11.013
6. Lenisa L, Tragni G, Belli F, Gallino G, Mascheroni L, Cascinelli N. Solitary melanoma metastasis of the kidney: A case report. Tumori. 1996;82(6):614–5. https://doi.org/10.1177/030089169608200621
7. Klatte T, Rao JY, Ribas A, Pantuck AJ. Metastatic melanoma to the kidney presenting with renal vein tumor thrombus. Urology. 2007;69(5):982.e7–9. https://doi.org/10.1016/j.urology.2007.02.032
8. Tajima K, Saito K, Umeda Y, Murata T, Sataniet H. Malignant melanoma of the kidney presenting as a primary tumor. Int J Urol. 1997;4(1):94–6. https://doi.org/10.1111/j.1442-2042.1997.tb00149.x
9. Bayazit Y, Aridogan IA, Zeren S, Gönlüşen G, Tansug Z. Primary malignant melanoma of the kidney. Scand J Urol Nephrol. 2002;36(1):77–79. https://doi.org/10.1080/003655902317259427
10. Sosman JA, Moon J, Tuthill RJ, Warneke JA, Vetto JT, Redman BG, et al. A phase 2 trial of complete resection for stage IV melanoma: Results of Southwest Oncology Group Clinical Trial S9430. Cancer. 2011;117(20):4740–06. https://doi.org/10.1002/cncr.26111
11. Bello DM. Indications for the surgical resection of stage IV disease. J Surg Oncol. 2019;119(2):249–61. https://doi.org/10.1002/jso.25326
12. Enomoto LM, Levine EA, Shen P, Votanopoulos KI. Role of surgery for metastatic melanoma. Surg Clin North Am. 2020;100(1):127–39. https://doi.org/10.1016/j.suc.2019.09.011
13. O'Neill CH, McMasters KM, Egger ME. Role of surgery in stage IV melanoma. Surg Oncol Clin N Am. 2020;29(3):485–95. https://doi.org/10.1016/j.soc.2020.02.010
14. Faries MB, Lowe M. Metastasectomy in stage IV melanoma: How and when should we employ it? Ann Surg Oncol. 2023;30(9):5312–3. https://doi.org/10.1245/s10434-023-13760-5
15. Eskelin S, Pyrhonen S, Summanen P, Hahka-Kemppinen M, Kivelä T. Tumor doubling times in metastatic malignant melanoma of the uvea: Tumor progression before and after treatment. Ophthalmology. 2000;107(8):1443–9. https://doi.org/10.1016/s0161-6420(00)00182-2
16. Awh CC, Wilson MW. Symptomatic liver metastasis prompting diagnosis of uveal melanoma. Ocul Oncol Pathol. 2020;6(3)164–7. https://doi.org/10.1159/000503035
17. Wei AZ, Uriel M, Porcu A, Manos MP, Mercurio AC, Caplan MM, et al. Characterizing metastatic uveal melanoma patients who develop symptomatic brain metastases. Front Oncol. 2022;12:961517. https://doi.org/10.3389/fonc.2022.961517
18. Ramaiya KJ, Harbour JW. Current management of uveal melanoma. Expert Rev Ophthalmol. 2007;2(6):939–46. https://doi.org/10.1586/17469899.2.6.939
19. Mittendorf EA, Lim SJ, Schacherer CW, Lucci A, Cormier JN, Mansfield PF, et al. Melanoma adrenal metastasis: Natural history and surgical management. Am J Surg. 2008;195(3):363–8. https://doi.org/10.1016/j.amjsurg.2007.12.018
20. Mohamed A, Gonzalez RS, Lawson D, Wang J, Cohen C. Tumor stem cells (CD271, c-kit, SOX10) in Melanomas: Prognostic and outcome implications. Appl Immunohistochem Mol Morphol. 2014;22(2):142–5. https://doi.org/10.1097/PAI.0b013e3182910a3d
21. Saeed F, Osunkoya AO. Secondary tumors of the kidney: A comprehensive clinicopathologic analysis. Adv Anat Pathol. 2022;29(4):241–51. https://doi.org/10.1097/PAP.0000000000000338
22. Adamy A, Von Bodman C, Ghoneim T, Favaretto RL, Bernstein M, Russo P. Solitary, isolated metastatic disease to the kidney: Memorial Sloan-Kettering Cancer Center experience. BJU Int. 2011;108(3):338–42. https://doi.org/10.1111/j.1464-410X.2010.09771.x
23. Karagkiouzis G, Koulaxouzidis G, Tomos P, Spartalis ED, Konstantinou F, Charpidou A, et al. Solitary metastasectomy in non-small cell lung cancer. J BUON. 2012;17(4):712–8.
24. Zhou C, Urbauer DL, Fellman BM, Tamboli P, Zhang M, Matin SF, et al. Metastases to the kidney: A comprehensive analysis of 151 patients from a tertiary referral centre. BJU Int. 2016;117(5):775–82. https://doi.org/10.1111/bju.13194
25. Hsueh EC, Essner R, Foshag LJ, Ye X, Wang HJ, Morton DL. Prolonged survival after complete resection of metastases from intraocular melanoma. Cancer. 2004;100(1):122–9. https://doi.org/10.1002/cncr.11872
26. Kutikov A, Uzzo RG. The R.E.N.A.L. nephrometry score: A comprehensive standardized system for quantitating renal tumor size, location and depth. J Urol. 2009;182(3):844–53. https://doi.org/10.1016/j.juro.2009.05.035
27. Campbell SC, Clark PE, Chang SS, Karam JA, Souter L, Uzzo RG. Renal mass and localized renal cancer: Evaluation, management, and follow-up: AUA guideline: Part I. J Urol. 2021;206(2):199–208. https://doi.org/10.1097/JU.0000000000001911
28. Abrams HL, Spiro R, Goldstein N. Metastases in carcinoma; analysis of 1000 autopsied cases. Cancer. 1950;3(1):74–85. https://doi.org/10.1002/1097-0142(1950)3:1<74::aid-cncr2820030111>3.0.co;2-7
29. Hauser N, Giakas J, Robinson H, Davaro F, Hamilton Z. Utilization of partial cytoreductive nephrectomy in patients with metastatic renal cell carcinoma. J Clin Med. 2024;13(19):5767. https://doi.org/10.3390/jcm13195767
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Published
Sep 10, 2025
Article Details
How to Cite
Partial Nephrectomy as Management of Oligometastatic Cancer with Limited Systemic Treatment Options: A Case Report. (2025). Journal of Kidney Cancer, 12(3), 32-36. https://doi.org/10.15586/jkcvhl.v12i3.414
Section
Kidney Cancer: Case Reports
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Author Biography
Gerald P. Wright, Department of Surgical Oncology, Corewell Health Medical Group West, Grand Rapids, MI, USA
How to Cite
Partial Nephrectomy as Management of Oligometastatic Cancer with Limited Systemic Treatment Options: A Case Report. (2025). Journal of Kidney Cancer, 12(3), 32-36. https://doi.org/10.15586/jkcvhl.v12i3.414