Background: To date, no predictive factors are recognized and applied in the therapeutic choice for metastatic renal cell carcinoma. Due to significant side-effects and costs, which are relevant issues in this setting, optimization of treatments has become a priority.

Case Report: We herein report a case of complete remission of metastatic renal cell carcinoma after 1 year of treatment with sunitinib. Since pancreatic metastases were detected by a 68Ga-DOTA-NOC positron emission tomography, it was decided to perform a histological revision of the specimens, with immunohistochemical staining for neuroendocrine markers on the primary tumor.

Conclusion: On the basis of the detection of neuroendocrine markers on the primary neoplasm, together with pancreatic metastases positive on a 68Ga-DOTA-NOC positron emission tomography (PET), we hypothesize and discuss about a potential role of specific neuroendocrine markers as predictive indicators of response to sunitinib (and allegedly to other target therapies) in the treatment of this neoplasm.

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