Abstract
The authors report the case of a 57-year-old man with a solitary cerebral metastasis from a renal cell carcinoma that occurred 11 years after a nephrectomy. The brain metastasis was removed and no metastases were seen to other organs. Eight months after this brain surgery, the patient is alive and doing well. Further, his proliferating cell nuclear antigen labelling index value is very low. In a review of the literature, which includes this present case, only 9 cases of brain metastases from a renal cell carcinoma with latency period greater than 10 years after a nephrectomy have been reported. Eight cases that presented a solitary brain metastasis had good outcomes whereas one case of a multiple m:etastases had a poor outcome. The long interval of latency, extending from the nephrectomy to a symptomatic brain metastasis, may be attributed to the following mechanisms : (1) the slow-growing characteristics of a renal cell carcinoma, and (2) the possibility that there might have been a minute brain metastasis before the nephrectomy and that this metastasis grew very slow1y. Surgery is the recommended treatment for patients who develop a solitary brain metastasis from a renal cell carcinoma after a long disease-free interval, provided that there are no other metastatic lesions.
