Objective: Kidney cancer represents 5% of all adult malignancies in men and 3% in women. The most common type is clear cell renal cancer, representing about 70-80% of the total. The medical approach to renal cancer has changed in the last few years, especially with the use of immunotherapy and tyrosine kinase inhibitors.

Case presentation: We present a case of a 48-year-old man, affected by clear cell renal cell carcinoma, detected in 2014. After nephrectomy surgery, clinical-instrumental follow-up was initiated. After only one year, a recurrence of bone disease was documented. Therefore, different types of treatments were undertaken, including systemic therapy with anti-VEGF and immunotherapy. The last treatment was Lenvatinib. Besides these, loco-regional treatments were used, which provided good disease control over time.

Results: We analyzed the case of a patient who survived for 10 years after being diagnosed with clear cell renal cell carcinoma. During these years, the patient underwent 5 lines of treatment and several loco-regional treatments. The use of drugs such as Sunitinib and Cabozantinib allowed good control of the disease while also maintaining a good quality of life. We finally offered our patient treatment with Lenvatinib, based on a study comparing the latter with Everolimus and the combination of the two. Lenvatinib treatment, which started in July 2023 and ended in February 2024, helped to further increase survival and maintain a good quality of life.

Conclusions: The case we presented is an example of how, with a good succession of systemic and loco-regional treatments and multidisciplinary and tailored approaches, long survival can be achieved while also maintaining a good quality of life.