Belzutifan and Transarterial Embolization for Symptomatic Vaginal Metastasis from Renal Cell Carcinoma: A Case Report

Renal cell carcinoma (RCC) rarely metastasizes to the vagina, with approximately 80 cases reported, and no established treatment guidelines exist for management. We report a case of a 57-year-old woman with heavily pretreated, metastatic clear cell RCC who developed a symptomatic vaginal metastasis refractory to multiple systemic therapies and palliative radiation. She achieved complete clinical remission and significant radiographic regression following a novel combination of belzutifan (hypoxia-inducible factor 2 alpha inhibitor) and transarterial embolization, both well tolerated. This is the first documented case of this combined approach for RCC vaginal metastasis, suggesting a promising therapeutic strategy for managing rare, refractory metastatic sites.