Complete Resolution of Paraneoplastic Membranous Nephropathy Following Curative Therapy of Triple-Negative Breast Cancer

Abstract

A paraneoplastic syndrome, which includes glomerulopathy, is a manifestation of malignancy unexplained by direct tumor burden. Membranous nephropathy (MN) may be associated with malignancies that are primarily solid tumors of the lung, prostate and gastrointestinal tract. It is rarely associated with breast cancer. To our knowledge, we herein report the first case of MN associated with triple-negative carcinoma of the breast. The patient initially presented with MN as a paraneoplastic nephrotic syndrome. Treatment resulting in a complete pathological response of the breast cancer also resolved the MN. Neither has recurred after a 48-month follow-up. The patient exhibited autoantibodies against phospholipase A2 receptor and was also antinuclear antibody (ANA) and anti-Smith (anti-Sm) antibody positive. These results suggest that the neoplasm evoked an autoimmune response, which resolved with treatment. ANA and anti-SM positivity closely correlated with the neoplasm activity supporting this hypothesis.

Paraneoplastic Membranous Nephropathy in a Patient Diagnosed with Lung Carcinoma in Treatment Immunotherapy: A Case Report and Literature Review

“…Yu et al describe the case of an 80-year-old patient diagnosed with advanced lung cancer and paraneoplastic nephrotic syndrome who achieved remission after treatment with radiotherapy and later showed resolution of the nephropathy [5]. Khan et al report a clinical case of a patient with triple negative breast cancer who presented a secondary paraneoplastic nephrotic syndrome, after treatment she presented complete pathologic response of the breast cancer that also resolved the nephrotic syndrome without recurrence of either pathology after 48 months of follow-up [6].…”

Recent Advances in Clinical Diagnosis and Pharmacotherapy Options of Membranous Nephropathy in Iraqi Patients

“…In 2009, the M-type phospholipase A2 receptor (PLA2R) was discovered as the primary target in membranous nephropathy (MN). Anti-PLA2R antibodies have a high specificity and sensitivity of around 70-80% for primary membranous nephropathy (pMN) primary with various ethnic groups [35], but the prevalence of autoantibodies against PLA2R is unknown among Iraqi patients with MN [15]. Human podocytes express PLA2R, a 180-kDa transmembrane glycoprotein that is a member of the MR family of mannose receptors.…”

Soft tissue sarcoma mimicking an arteriovenous malformation – A case report and review of literature

“…VA can also mimic other conditions like lymphatic malformations, synovial sarcoma, and cutaneous cysts, requiring the use of different imaging modalities, such as MRI, to differentiate them and provide insights into their morphologic characteristics [ 13 ]. Furthermore, some hyper vascularized tumors could initially be misdiagnosed as AVM, as they can have obscure clinical and radiologic features including paraneoplastic, paracrine, and vascular syndromes [ [14] , [15] , [16] ]. For instance, several soft tissue tumors could mimic AVM and small asymptomatic or atypical Kaposiform Hemangioendotheliomas (KHEs) can be misdiagnosed as unusual variants of Infantile Hemangioma (IH) or other AVM [ [17] , [18] , [19] ].…”