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Yu H, Zhang S, Feng X, Gao F. Multiple myeloma following bone metastasis of renal cell carcinoma: a case report. Front Endocrinol (Lausanne) 2023; 14:1206368. [PMID: 38107521 PMCID: PMC10722259 DOI: 10.3389/fendo.2023.1206368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 11/14/2023] [Indexed: 12/19/2023] Open
Abstract
Background The clinical manifestations of multiple myeloma (MM) and bone metastatic tumor are both systemic bone pain, which is difficult to distinguish from imaging manifestations, leading to misdiagnosis and missed diagnosis. Case summary We reported a man with a unique case whose tumors were MM with bone metastatic tumor of clear cell renal cell carcinoma (CCRCC). Computed tomography (CT) showed multifocal osteolytic bone destruction, while magnetic resonance imaging (MRI) showed multifocal bone marrow infiltration with soft tissue mass. Pathology and immunohistochemistry established the diagnosis of the coexistence of myeloma with bone metastatic tumor of CCRCC in the spine. Immunotherapy and systemic chemotherapy were adopted in the clinic, and vertebral decompression was performed after anemia was corrected. This case with MM and bone metastatic tumor of CCRCC received radiotherapy and immunotherapy and acquired satisfying outcome after 1 year of follow-up. Conclusion It is difficult to differentiate MM and bone metastatic tumor on imaging, especially when there are bone lesions at the same time, which is an easily missed diagnosis and needs to be comprehensively evaluated in combination with functional procedures, clinical laboratory tests, and histopathology.
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Affiliation(s)
- Hong Yu
- Department of Radiology, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Shengnan Zhang
- Department of Radiology, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xiaohui Feng
- Department of Pathology, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Feng Gao
- Department of Pathology, The Third Hospital of Hebei Medical University, Shijiazhuang, China
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Aloui M, Ben Rejeb S, Boudokhan M, Dhaoui A, Ben Romdhane M, Belakhal S. Bone metastatic carcinoma coexisting with plasma cell myeloma: a case report. J Med Case Rep 2022; 16:477. [PMID: 36550523 PMCID: PMC9780091 DOI: 10.1186/s13256-022-03688-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 11/22/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE Multiple myeloma is a clonal plasma cell proliferation often causing bone lytic lesions. It is sometimes challenging to differentiate these lytic lesions associated with multiple myeloma from bone destruction due to a metastasis. Although coexistence of solid tumors and plasma cell myeloma in one patient has been described, synchronous skeletal metastases from both neoplasms occurring in the same bone lesion is exceptional. Indeed, only one case has been reported in the literature. CASE PRESENTATION Herein, we report a case involving a 68-year-old Caucasian male patient admitted to our department for coronavirus disease 2019 infection with incidental finding of multiple lytic bone lesions during hospitalization. Laboratory tests revealed an increased immunoglobulin G kappa M protein and high levels of carbohydrate antigen 19-9. Bone marrow aspiration showed increased atypical plasma cells consistent with multiple myeloma. Percutaneous image-guided biopsy of one of the osteolytic lesions was performed. Pathological examination identified both plasma cell neoplasm and poorly differentiated metastatic carcinoma within the same bone lytic lesions. CONCLUSION The present case raises awareness among clinicians and pathologists that clinical and radiologic suspicion of multiple myeloma may be within the spectrum of second primary malignancies.
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Affiliation(s)
- Marwa Aloui
- Pathology Department, Security Forces Hospital, Marsa, Tunisia
| | - Sarra Ben Rejeb
- Pathology Department, Security Forces Hospital, Marsa, Tunisia
| | - Manel Boudokhan
- Medicine Department, Security Forces Hospital, Marsa, Tunisia
| | - Amen Dhaoui
- Pathology Department, Security Forces Hospital, Marsa, Tunisia
| | | | - Syrine Belakhal
- Medicine Department, Security Forces Hospital, Marsa, Tunisia
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3
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Narwal A, Ramteke P, Kumar L, Mallick S. Renal cell carcinoma concomitant with multiple myeloma. J Pathol Transl Med 2022; 56:111-112. [PMID: 35306777 PMCID: PMC8934998 DOI: 10.4132/jptm.2022.01.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 01/21/2022] [Indexed: 11/17/2022] Open
Affiliation(s)
- Anubhav Narwal
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Prashant Ramteke
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Lalit Kumar
- Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - Saumyaranjan Mallick
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
- Corresponding Author: Saumyaranjan Mallik, MD Department of Pathology, All India Institutes of Medical Sciences (AIIMS), New Delhi 110029, India Tel: +91-9013957818, Fax: +91-11-26588663, E-mail:
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Dinh AR, Wong SW, Martin TG, Wolf JL, Webber AB. Outcomes of kidney transplant recipients with ESKD due to plasma cell dyscrasia: A case series. Clin Transplant 2021; 36:e14541. [PMID: 34797567 DOI: 10.1111/ctr.14541] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/12/2021] [Accepted: 11/13/2021] [Indexed: 11/28/2022]
Abstract
Transplant centers have historically been reluctant to proceed with kidney transplantation in individuals with plasma cell dyscrasias (PCDs) due to concern for high rates of PCD recurrence and PCD-related mortality. As novel therapies for PCDs have improved hematologic outcomes, strategies to optimize kidney transplantation in individuals with PCD-mediated kidney disease are needed. In this single-center case series we discuss our protocol for the transplantation of individuals with ESKD attributed to PCD as well as the hematologic and allograft outcomes of 12 kidney transplant recipients with ESKD attributed to PCD. Median follow-up time after kidney transplantation was 44 months (IQR 36, 84). All patients had a functioning allograft 1 year after kidney transplantation. 9/12 patients were alive and had a functioning allograft 5 years after kidney transplantation. Five patients experienced relapse of PCD (of whom three responded well to subsequent therapies) and four patients developed secondary malignancies, including three patients with urologic malignancies. This case series demonstrates that patients with kidney disease attributed to PCD have favorable outcomes with kidney transplantation. Transplant evaluation in patients with PCDs should involve a multidisciplinary team of transplant nephrologists and oncologists to select appropriate candidates. Providers should consider screening for urologic malignancies pre- and post-transplantation.
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Affiliation(s)
- Alex R Dinh
- Department of Medicine, Division of Nephrology, University of California, San Francisco, California, USA.,Department of Medicine, Kidney Transplant Service, University of California, San Francisco, California, USA
| | - Sandy W Wong
- Department of Medicine, Division of Hematology/Oncology/Blood and Marrow Transplant, University of California, San Francisco, California, USA
| | - Thomas G Martin
- Department of Medicine, Division of Hematology/Oncology/Blood and Marrow Transplant, University of California, San Francisco, California, USA
| | - Jeffrey L Wolf
- Department of Medicine, Division of Hematology/Oncology/Blood and Marrow Transplant, University of California, San Francisco, California, USA
| | - Allison B Webber
- Department of Medicine, Division of Nephrology, University of California, San Francisco, California, USA.,Department of Medicine, Kidney Transplant Service, University of California, San Francisco, California, USA
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Syler LB, Gooden C, Riddle N. Plasma Cell Myeloma Within a Renal Cell Carcinoma, an Intimate Histologic Relationship: A Case Report and Literature Review. Cureus 2021; 13:e12898. [PMID: 33654583 PMCID: PMC7904501 DOI: 10.7759/cureus.12898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 01/25/2021] [Indexed: 11/05/2022] Open
Abstract
The coexistence of two separate malignancies in a patient is a rare occurrence. Even more infrequent is the coexistence of a hematologic malignancy and a solid tumor. However, the relationship between renal cell carcinoma (RCC) and plasma cell myeloma (PCM) has been reported in previous studies. These studies described synchronous cases of RCC and PCM and demonstrated that this situation occurs more frequently than expected by probability calculations. We present, what we believe to be, the first reported case of RCC directly and physically involved by PCM and, we review the literature on the association between these malignancies and explore possible mechanisms for their higher than expected association. In describing this case, emphasis is made to describe unique histologic findings that could further support a more direct and intimate association between these tumors.
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Affiliation(s)
- Lee B Syler
- Pathology, University of South Florida, Tampa, USA
| | - Casey Gooden
- Pathology, Ruffolo, Hooper & Associates, Tampa, USA
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Berquist SW, Hassan AES, Miakicheva O, Dufour C, Hamilton Z, Shabaik A, Derweesh IH. Collision Tumor With Renal Cell Carcinoma and Plasmacytoma: Further Evidence of a Renal Cell and Plasma Cell Neoplasm Relationship? Urol Case Rep 2016; 6:50-2. [PMID: 27175345 PMCID: PMC4856332 DOI: 10.1016/j.eucr.2016.03.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 03/01/2016] [Accepted: 03/02/2016] [Indexed: 11/27/2022] Open
Abstract
Renal solitary extramedullary plasmacytomas belong to a group of plasma cell neoplasms, which generally have been associated with renal cell carcinoma. We present a case report of a patient with collision tumor histology of extramedullary plasmacytoma and clear cell renal cell carcinoma, the first in the known literature. Standard work-up for a plasma cell neoplasm was conducted and the mass was resected. The patient remains disease-free at 28 months post-surgery. The report calls into question pre-surgical renal mass biopsy protocol and suggests a relationship between renal cell carcinoma and plasma cell neoplasms.
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Affiliation(s)
- Sean W Berquist
- Department of Urology, UC San Diego Health System, La Jolla, CA, USA
| | | | - Olga Miakicheva
- Department of Urology, UC San Diego Health System, La Jolla, CA, USA
| | - Catherine Dufour
- Department of Urology, UC San Diego Health System, La Jolla, CA, USA
| | - Zachary Hamilton
- Department of Urology, UC San Diego Health System, La Jolla, CA, USA
| | - Ahmed Shabaik
- Department of Pathology, UC San Diego Health System, La Jolla, CA, USA
| | - Ithaar H Derweesh
- Department of Urology, UC San Diego Health System, La Jolla, CA, USA
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Padhi S, Sahoo PK, Banerjee D, Ghosh RN. Renal cell carcinoma and plasma cell myeloma: Unique association and clinical implications. Urol Ann 2014; 6:252-6. [PMID: 25125903 PMCID: PMC4127867 DOI: 10.4103/0974-7796.134292] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Accepted: 02/10/2013] [Indexed: 11/28/2022] Open
Abstract
Several case series, in the recent past, have postulated an association between plasma cell myeloma (MM) and renal cell carcinoma (RCC). Population-based data have revealed a bi-directional association between these two malignancies, which points to shared risk factors, similar cytokine (Interleukin-6, IL-6) requirements for growth and survival, and overlapping clinical presentation. The presence of lytic lesions in a patient with prior RCC may simulate bone metastasis; thus, leading to a diagnostic pitfall with potentially adverse clinical implications. Besides these, therapeutic strategies employed for MM have been tried for RCCs with partial success. We aimed to describe two patients, aged 64 and 54 years, with RCC-MM association, with review of relevant literature; and create awareness among pathologists/hematologists, and oncologists. Elucidating a common genetic basis might throw some light in understanding the pathobiology of these tumors and development of newer targeted therapies.
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Affiliation(s)
- Somanath Padhi
- Department of Pathology, Pondicherry Institute of Medical Sciences, Ganapathychettykulam, Kalapet, Puducherry, India
| | - Pradyumna Kumar Sahoo
- Department of Surgical Oncology, Cancer Center Welfare Home and Research Institute, Thakurpukur, Kolkata, West Bengal, India
| | - Debashis Banerjee
- Department of Urology, Cancer Center Welfare Home and Research Institute, Thakurpukur, Kolkata, West Bengal, India
| | - Rabindra Nath Ghosh
- Department of Hemato-Oncology, Cancer Center Welfare Home and Research Institute, Thakurpukur, Kolkata, West Bengal, India
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Padhi S, Mokkappan S, Varghese RGB, Veerappan I. Plasmablastic multiple myeloma following clear cell renal cell carcinoma. BMJ Case Rep 2014; 2014:bcr-2014-204778. [PMID: 25103318 DOI: 10.1136/bcr-2014-204778] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We aim to describe the clinicohaematological profile of an elderly male with plasmablastic multiple myeloma (MM) (IgG λ, International System Stage II) with an unfavourable outcome following chemotherapy. The serum interleukin-6 level was found to be markedly elevated (2464 pg/mL, reference; <50 pg/mL). Thirty-six months prior to MM diagnosis, he underwent left radical nephrectomy for a stage III (pT3N0M0) clear cell renal cell carcinoma (RCC, Fuhrman grade 2). The unique MM-RCC association, shared risk factors, myeloma pathobiology and clinical implications are discussed with a brief literature review.
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Affiliation(s)
- Somanath Padhi
- Department of Pathology, Pondicherry Institute of Medical Sciences, Pondicherry, India
| | - Sudhagar Mokkappan
- Department of General Medicine, Pondicherry Institute of Medical Sciences, Pondicherry, India
| | - Renu G' Boy Varghese
- Department of Pathology, Pondicherry Institute of Medical Sciences, Pondicherry, India
| | - Ilangovan Veerappan
- Department of Nephrology, Pondicherry Institute of Medical Sciences, Pondicherry, India
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Sargın G, Yavasoglu I, Doger FK, Kadikoylu G, Bolaman Z. A coincidence of renal cell carcinoma and hematological malignancies. Med Oncol 2012; 29:3335-8. [PMID: 22843308 DOI: 10.1007/s12032-012-0316-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Accepted: 07/17/2012] [Indexed: 02/08/2023]
Abstract
Hematological malignancies with renal cell carcinoma (RCC) are rarely seen. We reported here two cases of coincidence of RCC with multiple myeloma (MM) and Hodgkin's disease (HD). A 69-year-old male patient with tumor that was located at the upper pole of left kidney was admitted to our clinic. Partial tumoral resection was performed and stage-I RCC was diagnosed after the histopathological examination of tumor. Moreover, he was diagnosed with IgG kappa stage-IIA MM as a result of bone marrow examination and serum immunofixation electrophoresis. Radiotherapy, combination chemotherapy, and autologous stem cell transplantation (ASCT) were performed. The patient is still alive who achieve a complete remission. A 53-year-old male patient suffered from cervical lymphadenopathy. He has a story of right radical nefrectomy that has been performed 4 years ago. Stage II-B lymphocyte-predominant HD was diagnosed. Combination chemotherapy was started, but relapse occurred 25 months later. ASCT was not planned due to cardiovascular problems and the patient died. Clinicians should keep in mind the coincidence of RCC with MM and HD.
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