Clear cell renal cell carcinoma presenting as isolated symptomatic lumbar vertebral metastasis: a case report
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By
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Jinyan Wang
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Qiaoqiao Jiang
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Tong’en Chen
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June 30, 2026
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Clinical Scorecard: Isolated Symptomatic Lumbar Vertebral Metastasis as the Initial Presentation of Clear Cell Renal Cell Carcinoma: A Case Study
At a Glance
| Category | Detail |
|---|
| Condition | Clear Cell Renal Cell Carcinoma (ccRCC) |
| Key Mechanisms | Metastasis to lumbar vertebrae presenting as isolated bone lesions. |
| Target Population | Adults with renal cell carcinoma, particularly those with atypical presentations. |
| Care Setting | Multidisciplinary team management for metastatic renal cell carcinoma. |
Key Highlights
- Rare case of ccRCC presenting as isolated lumbar vertebral metastasis.
- Initial misdiagnosis due to elevated PSA levels suggesting prostate cancer.
- Importance of multimodal imaging and histopathological evaluation in diagnosis.
- Successful treatment with a combination of axitinib and toripalimab.
- Significant regression of both primary and metastatic lesions after treatment.
Guideline-Based Recommendations
Diagnosis
- Utilize multimodal imaging and histopathological evaluation for bone lesions of unknown primary origin.
Management
- Follow first-line treatment guidelines for advanced ccRCC with targeted and immunotherapeutic regimens.
Monitoring & Follow-up
- Regular follow-up imaging to assess treatment response and monitor for disease progression.
Risks
- Potential for misdiagnosis due to misleading tumor markers such as elevated PSA.
Patient & Prescribing Data
62-year-old male with isolated lumbar vertebral metastasis from ccRCC.
Combination therapy with axitinib and toripalimab, along with denosumab for bone protection.
Clinical Best Practices
- Maintain a high index of suspicion for RCC in patients with isolated bone metastasis.
- Involve a multidisciplinary team for comprehensive management of metastatic RCC.
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