Sorafenib-induced tumor response in a patient with metastatic epithelioid angiomyolipoma.

Abstract

Case Report A 30-year-old man with a history of epithelioid angiomyolipoma of the kidney was admitted to our hospital in June 2011 with newly found lung nodules. Five years previously, he had undergone right radical nephrectomy at our institution for a 9.5-cm kidney mass. Pathologic examination of the nephrectomy biopsy showed sheets of large, oval tumor cells with a high degree of nuclear pleomorphism and macronucleoli (Fig 1A; hematoxylin and eosin [H&E], 400 magnification). The neoplastic cells showed diffuse and strong human melanoma black (HMB) -45 immunoreactivity (Fig 1B; HMB-45, 200 magnification) and were diagnosed as epithelioid angiomyolipoma (E-AML). The patient had no family history of tuberous sclerosis. Annual computed tomography (CT) scans showed no recurrence lesions or metastasis until March 2009. The patient was lost to follow-up in May 2009, but returned to our hospital in June 2011 when a CT scan from another hospital showed two lung nodules in the left upper lobe (LUL; 3.5-cm LUL lingular nodule; 1.9-cm LUL

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