Renal Abscess Caused by Crizotinib: A Rare Case Report

Abstract

Crizotinib is a tyrosine kinase inhibitor that has been found to be effective in the treatment of c-ros oncogene 1-positive non-small cell lung cancer. Although this targeted agent for treating cancer has shown superiority to standard chemotherapy in some ways, this drug has adverse effects, such as the development of renal abscesses. Some associated renal damage may disappear with crizotinib withdrawal. Hence, we present the case of a 58-year-old man with non-small cell lung cancer on crizotinib therapy who developed bilateral renal abnormal space-occupying lesions, successively which were difficult to identify using various imaging methods; even PET-CT highly suspected the right renal masses as malignant. Finally, the right renal lesions were confirmed as renal abscesses by postoperative pathology. The left renal lesion was considered as renal cysts through the lesion disappearing after crizotinib withdrawal. There have been very few reports in this respect, especially proved by various methods and confirmed by postoperative pathology. It is important to recognize this drug-related complication in order to avoid incorrect diagnosis and inadequate therapy. It is necessary to monitor renal changes after taking crizotinib.

Development of crizotinib-associated renal cyst in a non-small cell lung cancer patient with ALK fusion: a case report and review of the literature

“…While pathogenetic mechanism of autosomal dominant polycystic kidney disease (ADPKD) might be different from that of CARC, it has been reported that hepatocyte growth factor (HGF) and its receptor, c-MET, to be involved in the formation of ADPKD [ 26 , 27 ]. In this regard, crizotinib is a dual c-MET and ALK inhibitor [ 10 , 15 – 17 ], but accumulating number of case reports demonstrated that crizotinib is associated with development of cystic lesions in the kidneys, liver, and pancreas [ 20 , 24 , 28 – 35 ]. While the mechanism of CARC formation remains to be defined, as proposed by Wiest et al [ 30 ], complete collection of the following information from the advanced NSCLC patients treated with crizotinib is recommended, that is, patient’s general information including age, gender, race/ethnicity, history of renal cysts; clinical information of primary including stage at diagnosis, genetic information, treatment history, treatment response, PFS; tyrosine kinase inhibitor-associated renal cysts including time to diagnosis, laterality, pathology, symptoms, complications, abnormalities in vitals and labs.…”