本文报道一例因发现肺占位性病变继而确诊晚期肾癌的男性病例。患者因"反复咳嗽1年，前胸部疼痛2周"至珠海市中西医结合医院就诊。查胸部、全腹CT显示左肺下叶肺癌伴肺内多发转移，全身多处包括双肾可见转移瘤。进一步对肺部肿物进行穿刺活检，病理结果显示为腺癌，结合免疫组化结果，考虑肿瘤来源于肾脏。经院内多学科讨论和与患方沟通后决定予特瑞普利单抗联合阿昔替尼靶免治疗，以及辨证施膳，予中医中药治疗。经过5个靶免治疗疗程后，患者肿瘤显著缓解。经广东省医学会泌尿外科疑难病例多学科会诊，专家建议可继续维持靶免治疗并联合中医中药治疗，但需谨慎肝功能损害。此外，可完善PET-CT以及肾穿刺活检。经与患方沟通后，继续予靶免治疗，行PET-CT检查提示肺部及肾脏肿瘤明显缩小，其他部位未见明显高代谢。综上所述，对于晚期肾癌患者，靶向免疫治疗联合中医治疗的疗效确切，具有一定的推广价值。

This article presents a case of advanced renal cell carcinoma in a male patient, diagnosed following the identification of a pulmonary space-occupying lesion. The patient presented to Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine due to persistent coughing for one year and anterior chest pain for two weeks. Chest and abdominal CT scans revealed lung cancer located in the lower lobe of the left lung, accompanied by multiple intrapulmonary metastases as well as metastatic tumors throughout other regions of the body including both kidneys. A biopsy was performed on the pulmonary mass, with pathological analysis confirming adenocarcinoma. Based on immunohistochemical findings, it was determined that the tumor likely originated from the kidney. Following multidisciplinary discussions within the hospital and consultations with the patient's family, a treatment plan involving toripalimab combined with axitinib for targeted therapy and immunotherapy was established, alongside traditional Chinese medicine tailored to syndrome differentiation and dietary therapy. After five courses of this combined treatment regimen, significant regression of the patient's tumors was observed. Subsequent multidisciplinary consultation conducted by Guangdong Urological Association, the experts recommended continuing targeted therapy and immunotherapy while monitoring liver function closely, they also suggested integrating traditional Chinese medicine treatments along with performing PET-CT imaging and renal biopsy if feasible. Upon further discussion with the patient's family, continuation of targeted therapy and immunotherapy proceeded as planned. The PET-CT results indicated substantial reductions in both lung and kidney tumors without any evident hypermetabolism detected in other areas. In conclusion, this case illustrates that combining targeted therapies with immunotherapy alongside traditional Chinese medicine can yield effective outcomes for patients suffering from advanced renal cell carcinoma.