4CPS-211 Abstract withdrawn

<h3>Background and Importance</h3> Renal cell carcinoma is amongst the 10 most common types of cancer in the western world^{1 2} and the main risk factors are age and hypertension.³ <h3>Aim and Objectives</h3> This study aims to describe a clinical case of clear cell renal cell carcinoma (ccRCC) with lung metastases (LM), without nephrectomy. <h3>Material and Methods</h3> This clinical case method was observational and retrospective. The data were obtained from SClinic, GHAF and CliniData. This case addresses a 44 year-old female, without smoking or drinking habits, normotensive. The patient´s family has history of cancer, her father has prostate adenocarcinoma. A progressive cough, associated with recurrent fatigue, led her to visit the Emergency Department. Computed Tomography (CT), identified the presence of a neoplastic-looking mass in the right kidney, measuring 9 x 8 cm, hypervascular and heterogeneous and LM were observed. Abdomen was soft and depressed, with a palpable mass in the right flank. Laboratory tests did not present any relevant alterations. The diagnosis was ccRCC, confirmed by biopsy, with multiple intermediate risk LM and the patient remained unchanged at a cognitive and physical level. To date, the patient has undergone four lines of treatment: 1st - Pembrolizumab 200 mg, IV, 3/3 weeks (w) + axitinib 5 mg every 12 hours, tablet (tabs) - 10 cycles (C) - 6 months (m). Adverse drug reactions (ADR): headaches, worsening cough, changes in thyroid and liver function and musculoskeletal pain. 2nd - Cabozantinib 60 mg/day, tabs, reduced to 40 mg/day - 6 m. ADR: rash in both hands, elbows and feet. 3rd - Sunitib 50 mg/day, tabs – 1 m. 4th – Ipilimumab 1mg/kg, IV + nivolumab 3mg/kg, IV, 3/3 s. – 4 C. Nivolumab 480 mg, IV, 4/4 s, as monotherapy, which is maintained to present. <h3>Results</h3> Given the severity and advanced initial staging, despite pharmacological intervention, the disease continues to progress. The 1st line of treatment was the one that showed the best CT results. <h3>Conclusion and Relevance</h3> As this is a patient under 50 years of age, with no associated risk factors and no disease progression, this is considered a rare and interesting clinical case. <h3>References and/or Acknowledgements</h3> &lt;https://www.scielo.br/j/rb/a/qhxhqqs4Jfr3MVG5pBtnFDt/abstract/?lang=pt&gt; &lt;https://periodicorease.pro.br/rease/article/view/14932/7752&gt; &lt;https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8699019/&gt; <h3>Conflict of Interest</h3> No conflict of interest