Preoperative ipilimumab/nivolumab combination therapy reduced operation risk by downstaging the inferior vena cava tumor thrombus extending to the right atrium in a metastatic renal cell carcinoma: A case report

Figures

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  Fig. 1. Representative magnet resonance imaging (MRI), computed tomography (CT), and echocardiography at the time of diagnosis (a, b, c), and after four courses of preoperative ipilimumab/nivolumab combination therapy (d, e, f). Primary tumor and pulmonary metastases showed partial response, and IVC tumor thrombus was significantly downstaged from level IV to level I.

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  Fig. 2. Pathological assessments. HE staining (a, b), immunostaining of CD68 (c) and AE1/AE3 (d) of the primary tumor. CD68 shows macrophage, and AE1/AE3 shows where viable cell exists. It was clear cell renal cell carcinoma, and around the viable lesion, there was immune activation with dense tumor infiltrating macrophage and massive cell death with cholesterol clefts, which were the features of immune-related pathologic response.