Primary adenocarcinoma of the renal pelvis: A case report

This case underscores the imperative for multimodal integration (surgery, chemotherapy, and ICIs) to optimize survival in advanced renal pelvic adenocarcinoma while highlighting the necessity of dynamic therapeutic adaptation-including regimen rechallenge and tyrosine kinase inhibitor combinations-to address recurrence and resistance. Proactive toxicity management (e.g., dose de-escalation for renal injury) and rigorous biomarker-driven surveillance (serial CA19-9 tracking with 3-month imaging) emerge as critical strategies to balance efficacy and safety in this aggressive malignancy.