Concurrent Renal Cell Carcinoma and Central Nervous System Lymphoma in a Patient with Autosomal Dominant Polycystic Kidney Disease

Abstract

Objective: To report an unusual case of synchronous renal cell carcinoma and CNS lymphoma in a patient with autosomal dominant polycystic kidney disease (ADPKD). Case Presentation and Intervention: A 58-year-old woman presented with progressive right hemiparesis of 2 months’ duration. A brain CT scan revealed multiple enhanced lesions in the basal ganglia and the right occipital lobe. CNS lymphoma was confirmed by a stereotactic biopsy. Polycystic kidneys and a right renal mass were found incidentally. It was decided to treat the patient with cranial radiotherapy and chemotherapy first. The patient achieved complete remission of CNS lymphoma after 3 months, but the renal mass remained unchanged. A needle biopsy of the renal mass revealed renal cell carcinoma and unilateral nephrectomy was performed successfully. The patient remained in complete remission at 6-year follow-up. Conclusion: The patient was treated successfully with a combination of chemotherapy, radiotherapy, and unilateral nephrectomy. This report highlights the need for clinicians to remain alert to the possibility of double malignancies while caring for ADPKD patients, especially when multiple unexplained manifestations exist.

Is There an Association between Advanced Stage of Renal Cell Carcinoma and Paraneoplastic Syndrome?

“…In these patients, elevated red blood cell concentration is believed to be mediated by erythropoietin, a glycoprotein that induces differentiation of erythrocyte colony-forming units in the bone marrow to promote red blood cell production. Neurological PNS are rare in RCC conditions yet can be successfully treated by resection of the primary tumor [16,17]. In our cohort, the 12 cases who were found to have neuromyopathy associated with RCC all experienced more or less alleviation of their condition postoperatively.…”

Synchronous or collision solid neoplasms and lymphomas: A systematic review of 308 case reports

“…1). [12–262] The data were extracted from the abstract in 34 articles, [17,37–39,64,75,76,78,81,94,97,103,129,134,151,162,166,170,174,176,192,195,212,221,222,229,232,234,251,252,256,260–262] of which 21 were in English, 5 in Japanese, 3 in Spanish, 2 in French, 2 in Chinese, and 1 in Czech.…”