Recurrent intracranial hemorrhage without brain metastasis after VEGFR TKI rechallenge in metastatic renal cell carcinoma: a case report and literature review

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VEGFR TKIs are standard treatments for metastatic renal cell carcinoma but can cause hemorrhagic events, including rare intracranial hemorrhage.
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A 52-year-old man with metastatic clear cell RCC experienced recurrent cerebellar hemorrhage after VEGFR TKI rechallenge, leading to rapid clinical deterioration.
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Initial treatment included immunotherapy and sunitinib, which achieved a partial response before the patient developed multifocal cerebellar hemorrhages.
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Surgical intervention confirmed the absence of brain metastases, and the patient had complete radiologic resolution of the hemorrhage postoperatively.
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The case suggests that early VEGFR TKI rechallenge after CNS hemorrhage may be unsafe, necessitating careful risk-benefit assessment.

Frontiers In Oncology

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