[A case of recurrent renal cell carcinoma which recurred after fourth surgical resection and survived for about 2 years by medroxyporgesterone acetate administration].

A 62-year-old man visited our hospital complaining of asymptomatic gross hematuria. Right radical Computed tomography (CT) demonstrated an 8 cm mass in the right kidney. nephrectomy was done in March 1995, and the pathological examination revealed renal cell carcinoma (RCC), clear cell type, G2>G1. Interferon (IFN)-alpha was administered for 10 months. About 3 years later, in March 1998, CT showed 1 cm mass in the left kidney. Left partial nephrectomy was done and the pathological finding was RCC, G1. IFN-alpha2b was administered for a year. About 2 years later, CT showed 2.7 cm mass in the left lung. Left upper lobectomy was performed in August 2000, and it was a metastasis of RCC, G2. IFN-alpha and IFN-gamma were administered. Nine months later, in June 2001, the recurrence of the left kidney and the left adrenal gland was found and partial nephrectomy and adrenalectomy was performed. Pathological finding was RCC, G3. IFN-alpha and tegafur-uracil (UFT) were administered. Only 3 months later, recurrence of the left kidney and the left adrenal gland and the lymph node of renal hilus was found. We gave up for surgical resection and chemotherapy of MVP (Methotrexate, Vinblastine, Pepleomycin) was performed. Despite the therapy, disease progressed. 10 months after the last recurrence, in July 2002, patient became disoriented and hypercalcemia and the MVP therapy was stopped. After that, medroxyprogesterone acetate (MPA) and UFT were administered; the patient lived 20 months with relatively good performance status and died in February 2004. MPA might be considered as a drug for advanced renal cell carcinoma.