A patient with esophageal cancer showing remission of nephrotic syndrome after esophagectomy: report of a case

Abstract

A 73-year-old male patient was admitted to our hospital due to bilateral leg edema and proteinuria in April 2009. After admission, nephrotic syndrome (membranous nephropathy) was diagnosed. At that point, a cancer screening test was performed; however, no abnormalities were noted. Medical treatment with prednisolone and cyclosporine was started, which resulted in the temporary improvement of markers of laboratory data. The patient was re-examined in November of the same year, and esophageal cancer (squamous cell carcinoma, T2N0M0 Stage IIA according to the UICC TNM classification) was detected in the lower thoracic esophagus. Subtotal esophagectomy was performed via right thoracolaparotomy with two-field lymph node dissection. Although the patient's course was complicated by respiratory failure, he was discharged after 38 days. After performing esophagectomy, prompt amelioration of the nephrotic syndrome occurred, allowing the withdrawal of prednisolone and cyclosporine. There has been no recurrence of esophageal cancer or relapse of nephrotic syndrome during a period of 18 months after esophagectomy.

Remission of nephrotic syndrome after surgical intervention for bronchogenic carcinoma: the 10-year follow-up of a patient with membranous nephropathy

“…However, the surgical removal of the tumor bulk may lead to remission from the renal manifestations in some subsets of patients with paraneoplastic kidney injury,4,5,21–23 and radiotherapy as well as chemotherapy can also be an attractive therapeutic option for patients with advanced unresectable neoplastic disease 15,24–26. On the other hand, it has been recommended that the administration of immunosuppressive agents be avoided when treating MN because they may exacerbate the concurrent malignancy 2,14.…”