A rare case of bilateral lung metastasis from renal cell carcinoma 26 years after nephrectomy

Renal cell carcinoma (RCC) is a malignant tumor that often metastasizes early. About 33% of RCC patients present with metastatic masses, mostly in the lungs. Our patient was a 66-year-old woman who had a left-sided nephrectomy for RCC 26 years ago. Prior to the current presentation, she sought medical advice for about a year because of her easy fatigability, which was attributed to her normocytic normochromic anemia. Incidentally, a mass was discovered in each lung, which was found histopathologically and immunohistochemically to be a metastasis of RCC. The patient received sunitinib, which is the standard treatment for patients with advanced RCC and metastases without benefit at initial doses and cycles. Consequently, the dose was increased up to four times the initial dose, and by the third cycle, side effects appeared in the form of impaired consciousness up to deep coma, hypertension, hypercarotenemia, pancytopenia, hyponatremia, hypokalemia, and subclinical hypothyroidism. She was taken to the hospital and then sadly passed away.