Abstract
A 52-year-old womanwith hypothyroidism and advanced renal cell carcinoma presented with new onset headache, worsening fatigue, and weakness for two weeks. Two years back she developed flank pain, and underwent radical nephrectomy and extended lymph node dissection for a left renal mass. Pathology showed clear cell carcinoma with lymph nodemetastasis and extensive lymphovascular invasion. She received adjuvant therapy with pazopanib, and was referred for a clinical trial after she had disease progression. At the time of presentation, she had been receiving immunotherapy with an immune checkpoint inhibitor ipilimumab for two months as a part of a clinical trial. A magnetic resonance imaging (MRI) of the brain with contrast is shown in Fig. 1.
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