Pulmonary metastasis from renal cell carcinoma 17 years after nephrectomy: report of two cases.

We herein report two cases of pulmonary metastasis from renal cell carcinoma with 17-year disease-free intervals. Despite long disease-free intervals, their clinical course after pulmonary resection was different. An 82-year-old man (case 1) and a 73-year-old man (case 2), with histories of having undergone left nephrectomy for clear-cell-type renal cell carcinoma 17 years ago, were found to have right pulmonary nodules, which were detected incidentally by chest roentgenograms. A chest computed tomography revealed the presence of nodules in the right lung. They underwent surgical pulmonary resection 17 years after nephrectomy. These tumors were diagnosed as metastatic renal cell carcinoma. Currently, the case 1 patient is doing well with no signs of recurrence 42 months after pulmonary metastasectomy; however, the case 2 patient was found to have multiple tumor recurrences 11 months after metastasectomy. Their clinical courses indicate that a longer disease-free interval does not always imply a favorable prognosis.