TREATMENT WITH INTERFERON-ALPHA AND CIMETIDINE FOR RENAL-CELL CARCINOMA WITH TUMOR THROMBUS EXTENDING INTO THE INFERIOR VENA-CAVA

A case of renal cell carcinoma is reported in which interferon therapy was successful in reducing the primary lesion and tumour thrombus. CT and MRI in this case revealed a tumour at the lower pole of the right kidney and a tumour thrombus in the inferior vena cava extending from the right renal vein into the incurrent region of the hepatic vein. No abnormal findings were detected by chest X-ray or bone scan. Thus, this case was diagnosed as T3NOMOV2b. Radical operation using an extracorporeal circulation system was considered too risky as initial treatment, due to the patient's past history of myocardial infarction. After coronary angioplasty, natural interferon-alpha was injected i.m. at 5 000 000 units a day and cimetidine was administered at 800 mg a day orally. Six months after the start of this combination therapy, the primary lesion and the tumour thrombus were markedly reduced in size, and the clinical response was evaluated as partial response. Radical nephrectomy and extirpation of the tumour thrombus were, therefore, performed with extracorporeal circulation. Histopathologically, necrosis and lymphocyte infiltration into the cancer cell focus were seen. These immunological reactions were considered to be caused by interferon.