These results suggest that VD agents may be effective as a treatment for renal cell carcinoma, especially when micrometastases are involved.

These results suggest that VD agents may be effective as a treatment for renal cell carcinoma, especially when micrometastases are involved.

Renal metastases of osteogenic sarcoma are unusual clinical occurrence and cases of osteogenic sarcoma treated by nephrectomy for renal metastases have been rarely reported. We report a 19-year-old male who was successfully treated by left nephrectomy for a metastatic tumor of osteogenic sarcoma from the right femur. In 1989 above-knee amputation was performed and the initial relapse with right pulmonary metastasis was treated by right upper lobectomy in 1991. In February 1992 he developed left renal and left pulmonary metastasis, hence left nephrectomy and left upper lobectomy were performed. Metastases of osteogenic sarcoma to the organs other than the lung and bone will increase because of the improvement of diagnostic modalities. Our study suggests that a bone scan is useful for routine follow-up of patients with osteogenic sarcoma and that resection of the metastatic lesion can improve these patients' quality of life.

To determine whether interferon-alpha could augment antitumorigenic effect of the tumor-infiltrating lymphocytes expanded with interleukin-2, we evaluated the properties of interleukin-2 expanded tumor-infiltrating lymphocytes in 24 patients with renal cell carcinoma with or without treatment with interferon-alpha. Tumor-infiltrating lymphocytes containing tumor cells were separated from nephrectomy specimens by enzymatic digestion and Percoll gradient centrifugation, and were cultured in the serum-free medium containing interleukin-2. The number of lymphocytes increased by 10 to 1,000-fold by day 28 of culture. There was no difference in the proliferation of tumor-infiltrating lymphocytes between interferon-alpha treated patients and controls. On day 14 tumor-infiltrating lymphocytes in the treated patients contained significantly more activated cells (HLA-DR+) and suppressor T cells (CD8+11+) than those in the controls. No significant difference was noted, however, in the cytotoxicity of tumor-infiltrating lymphocytes against autologous and allogenic renal cell carcinoma, K-562 or Daudi cells between the experimental and control groups on day 14 or 28. No specific effects on the major histocompatibility antigens, such as modulation of the expression attributable to the preoperative treatment with interferon-alpha, were observed on renal cell carcinoma tissue when determined by immunohistochemical staining. These findings suggest that interferon-alpha does not consistently produce a beneficial effect on interleukin-2 expanded tumor-infiltrating lymphocytes in patients with renal cell carcinoma.

Our experience suggests that aggressive surgery should be considered in selected patients with non-metastatic renal cell carcinoma extending into the vena cava.