Case Discussion: A 63-year-old Male with Bilateral Adrenal Mass and Large Renal Cell Carcinoma: The Case for Chemotherapy

Patients with metastatic clear cell renal cancer should still be considered for cytoreductive nephrectomy, even though the evidence for this relates mainly to the period before modern systemic therapy. Metastasectomy should also be considered when there is a chance of complete surgical clearance. For patients with inoperable progressive metastases there are now a number of effective systemic therapies that should be considered. In the first-line setting, the options include the tyrosine kinase inhibitors sunitinib and pazopanib.