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Peer-reviewedCC BYIJU case reports

Recurrent TFE3-Rearranged Renal Cell Carcinoma Responding to Pembrolizumab Plus Lenvatinib After Postoperative Pembrolizumab: A Case Report.

  • Masashi Fujimoto1
  • Tomoyasu Sano1
  • Yuta Sano1
  • Satoshi Inoue1
  • Kazuna Matsuo1
  • Tomokazu Kimura1
  • Shohei Ishida1
  • Kenji Zennami1
  • Yoshihisa Matsukawa1
  • Shusuke Akamatsu1
  1. 1Department of Urology Nagoya University Graduate School of Medicine Nagoya Aichi Japan.
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Abstract

Introduction

TFE3-rearranged renal cell carcinoma (RCC) is rare, and evidence guiding systemic therapy is limited.Case presentation

A 25-year-old man with gross hematuria had a left renal tumor with hilar lymph node metastasis. Robot-assisted radical nephrectomy and hilar lymph node dissection were performed. Histology, immunohistochemistry, and fluorescence in situ hybridization confirmed TFE3-rearranged RCC, pT3aN1. Postoperative pembrolizumab was started because of the high risk of recurrence. Eight months after surgery, lung and retroperitoneal metastases developed. Lenvatinib was added to ongoing pembrolizumab. The metastatic lesions decreased within one month, and a partial response according to Response Evaluation Criteria in Solid Tumors has been maintained for ten months.Conclusion

This case suggests that adding a vascular endothelial growth factor receptor tyrosine kinase inhibitor to pembrolizumab may be a therapeutic option for recurrent TFE3-rearranged RCC, although longer follow-up and molecular characterization are needed.

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Cite

BibTeXRIS
BibTeX
@article{fujimoto2026recurrent,
  title = {{Recurrent TFE3-Rearranged Renal Cell Carcinoma Responding to Pembrolizumab Plus Lenvatinib After Postoperative Pembrolizumab: A Case Report.}},
  author = {Masashi Fujimoto and Tomoyasu Sano and Yuta Sano and Satoshi Inoue and Kazuna Matsuo and Tomokazu Kimura and Shohei Ishida and Kenji Zennami and Yoshihisa Matsukawa and Shusuke Akamatsu},
  journal = {IJU case reports},
  year = {2026},
  month = oct,
  doi = {10.1002/iju5.70280},
  url = {https://europepmc.org/article/MED/42899072},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Recurrent TFE3-Rearranged Renal Cell Carcinoma Responding to Pembrolizumab Plus Lenvatinib After Postoperative Pembrolizumab: A Case Report.
AU  - Masashi Fujimoto
AU  - Tomoyasu Sano
AU  - Yuta Sano
AU  - Satoshi Inoue
AU  - Kazuna Matsuo
AU  - Tomokazu Kimura
AU  - Shohei Ishida
AU  - Kenji Zennami
AU  - Yoshihisa Matsukawa
AU  - Shusuke Akamatsu
PY  - 2026
DA  - 2026/10/19
JO  - IJU case reports
DO  - 10.1002/iju5.70280
UR  - https://europepmc.org/article/MED/42899072
AB  - Introduction  TFE3-rearranged renal cell carcinoma (RCC) is rare, and evidence guiding systemic therapy is limited.Case presentation  A 25-year-old man with gross hematuria had a left renal tumor with hilar lymph node metastasis. Robot-assisted radical nephrectomy and hilar lymph node dissection were performed. Histology, immunohistochemistry, and fluorescence in situ hybridization confirmed TFE3-rearranged RCC, pT3aN1. Postoperative pembrolizumab was started because of the high risk of recurrence. Eight months after surgery, lung and retroperitoneal metastases developed. Lenvatinib was added to ongoing pembrolizumab. The metastatic lesions decreased within one month, and a partial response according to Response Evaluation Criteria in Solid Tumors has been maintained for ten months.Conclusion  This case suggests that adding a vascular endothelial growth factor receptor tyrosine kinase inhibitor to pembrolizumab may be a therapeutic option for recurrent TFE3-rearranged RCC, although longer follow-up and molecular characterization are needed.
SN  - 2577-171X
ER  -