Augusto (67 years old)

Augusto, 67 years old, owns a small book shop in his town. He was diagnosed with primary metastatic RCC 4 years ago.

Assessment summary 4 years ago:

• Metastatic sites: lung, bone, lymph nodes and adrenal gland
• Severe Crohn’s disease treated with active immune suppression
• IMDC: intermediate risk
• Biopsy of bone: histologically confirmed metastasis of ccRCC

Underwent laparoscopic cytoreductive nephrectomy on the right side 4 years ago

• pT2a, no lymphatic or venous invasion, no residual tumour
• Grade 3 ccRCC

First-line therapy with sunitinib (50 mg/day) on a ‘4 weeks on, 2 weeks off’ schedule was initiated shortly thereafter.

Now, 4 years later: disease progression, metastatic sites: lung, bone, lymph nodes and adrenal gland.