Complete response to carboplatin, gemcitabine, and paclitaxel in a patient with advanced metastatic renal medullary carcinoma

Walsh, Alexandra; Kelly, David R.; Vaid, Yoginder N.; Hilliard, Lee; Friedman, Gregory K.

doi:10.1002/pbc.22611

Cited by 44 publications

(37 citation statements)

References 15 publications

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“…The most significant clinical challenge presented by RMC is that chemo-, immuno-and radiotherapy have all been unsuccessful for the treatment of RMC, based on previous studies (4,5,(17)(18)(19)(20)(21)(22). Therefore, an early diagnosis may improve the survival rates of patients with RMC.…”

Section: Discussionmentioning

confidence: 99%

Clinical and computed tomography imaging features of renal medullary carcinoma: A report of six cases

et al. 2015

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Abstract. Patients with renal medullary carcinoma (RMC) have a poor prognosis, usually due to late diagnosis. Computed tomography (CT) analysis may aid the differentiation between RMC and other types of renal cell carcinoma, in order to establish an accurate early diagnosis. There is a limited number of reports in the literature focusing on clinical and multi-slice CT (MSCT) imaging findings of RMC. Consequently, the present study aimed to characterize the clinical and MSCT imaging features of RMC. For this purpose, the MSCT imaging findings of 6 patients with RMC were retrospectively studied. The patients were subjected to MSCT in order to investigate the characteristics of the tumors, including location, size, density, calcification, cystic or solid appearance, capsule sign, enhancement pattern and presence of retroperitoneal lymph node metastasis. The tumors in the current study presented a mean diameter of 7.48±3.25 cm, and were observed to be solitary and heterogeneous with necrotic components. The majority of the tumors did not contain calcifications (5/6); displayed an ill-defined margin (4/6); were centered in the medulla; extended into the renal pelvis or peripelvic tissues (6/6); and did not exhibit a fibrous capsule. Localized caliectasis was observed in 3 of the 6 cases. The attenuation of the solid region of the RMC on unenhanced CT was equal to that of the renal cortex or medulla (42.3±2.7 vs. 40.7±3.6 and 41.2±3.9 Hounsfield units, respectively; P>0.05) while, on enhanced CT, the enhancement of the tumor was lower than that of the normal renal cortex and medulla during all phases (cortical phase, 52.6±4.8 vs. l99.5±9.7 and 72.7±6.4; medullary phase, 58.6±5.7 vs. 184.6±10.8 and 93.5±7.8; delayed phase, 56.8±6.1 vs. 175.7±8.5 and 96.5±7.9, respectively; P<0.05).In conclusion, RMC tends to be an infiltrative, ill-defined heterogeneous mass with intratumoral necrosis, which arises from the renal medulla, and displays lower enhancement than the renal cortex and medulla during all phases on enhanced CT. Despite its rarity in adults, RMC should be included in a differential diagnosis when CT imaging reveals these features.

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Section: Discussionmentioning

confidence: 99%

Clinical and computed tomography imaging features of renal medullary carcinoma: A report of six cases

et al. 2015

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“…First-line treatment may include cytotoxic chemotherapy with palliative intent, as most patients still die within 1 year of diagnosis. 1 Walsh et al 6 reported an 11-year-old African American male patient with sickle cell trait, with advanced metastatic renal medullary carcinoma that was treated with a paclitaxel, gemcitabine, and carboplatin regimen. There was an initial appropriate response to systemic therapy; however, he ultimately had disease progression with leptomeningeal involvement, and he died 24 months after initial diagnosis.…”

Section: Further Diagnostic Assessment and Managementmentioning

confidence: 98%

A Heterogeneous Renal Mass and Arm Pain in a 38-Year-old African American Female

Klaassen

Peard

Wilhelm

et al. 2015

Urology

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“…Partial responses were obtained on a short period using the MVAC regimen (methotrexate, vinblastine, doxorubicin, and cisplatin) [7]. Responses have also been reported using cisplatin or carboplatin in combination with gemcitabine and paclitaxel, however, death occurred 10, 12 and 24 months after the diagnosis [8]. Only two studies reported on patients in continuous remission [5,9].…”

Section: Discussionmentioning

confidence: 99%

Transitory Complete Response to the EpSSG Extracranial Rhabdoid Tumor Protocol in a White Adolescent with a Sickle Trait Harboring a Metastatic Renal Medullary Carcinoma

Chastagner¹,

Costanzia²,

Phulpin-Weibel³

et al. 2014

Arch Clin Cases

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Renal medullary carcinoma (RMC) is a very rare disease that is almost exclusive to young black patients with sickle cell trait. Most patients present with metastatic disease at diagnosis and have a grim prognosis. Histologic diagnosis of these tumors can be difficult in the presence of rhabdoid elements and loss of INI1 expression as observed in our case.We describe the first known reported case of a white male adolescent with sickle cell trait, who was treated for a metastatic RMC with reticular pattern of rhabdoid-like cells and absence of INI1 expression, by the European Soft Tissue Sarcoma Study Group (EpSSG) protocol designed for rhabdoid tumors and who achieved a transitory complete response. Although complete remission was achieved, overall survival was not improved.

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Complete response to carboplatin, gemcitabine, and paclitaxel in a patient with advanced metastatic renal medullary carcinoma

Abstract: Renal medullary carcinoma (RMC) is a rare and aggressive malignancy seen primarily in patients with sickle-cell trait. We report a complete response to carboplatin, paclitaxel, and gemcitabine in a patient with advanced metastatic RMC.

Cited by 44 publications

References 15 publications

Clinical and computed tomography imaging features of renal medullary carcinoma: A report of six cases

Clinical and computed tomography imaging features of renal medullary carcinoma: A report of six cases

A Heterogeneous Renal Mass and Arm Pain in a 38-Year-old African American Female

Transitory Complete Response to the EpSSG Extracranial Rhabdoid Tumor Protocol in a White Adolescent with a Sickle Trait Harboring a Metastatic Renal Medullary Carcinoma

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