Ultra-late triple metastasis to the breast, lung, and brain 25 years after nephrectomy for clear cell renal cell carcinoma: a case report and literature review

This case highlights breast metastasis as a rare but critical differential diagnosis in patients with a history of ccRCC, even decades after initial treatment. It underscores the necessity of lifelong follow-up for ccRCC survivors and demonstrates the integral role of imaging and pathological confirmation in guiding clinical diagnosis. Furthermore, the remarkable 25-year latency period challenges existing surveillance paradigms and provides a compelling rationale for the use of combined immunotherapy and targeted agents in managing ultra-late, multi-metastatic recurrences.