Radical nephrectomy with en bloc resection of liver, diaphragm, and lung for locally invasive sarcomatoid renal cell carcinoma

Despite the widespread use of abdominal imaging, some patients with renal cell carcinoma still present with advanced disease. We report 1 case of locally invasive sarcomatoid renal cell carcinoma requiring resection of the kidney, adrenal glands, liver, diaphragm, and lung, with diaphragmatic reconstruction with a polytetrafluoroethylene patch. The patient was alive and well 5 years postoperatively. However, we acknowledge that the success experienced with this case does not represent the typical outcome for a patient with such advanced disease.