Clear Cell RCC with Lytic Bony Lesions: Metastasis or Multiple Myeloma, A Diagnostic Dilemna
Article Sidebar
Main Article Content
Abstract
Introduction: The existence of two malignancies together is very rare. Multiple myeloma and RCC occurring together is highly uncommon. Possible reason for co-existence may be similar cytokine growth requirements however no etiology has been proven for sure.
Case Presentation: We present a case with a renal lesion and bony lytic lesions suspected of being secondary osseous metastasis. However on further evaluation the bony lesions were found to be due to co-existent multiple myeloma.
Conclusion: The occurrence of RCC and MM together is higher than the expected incidence. The causative etiology may be genetic abnormalities, environmental exposures or immune-related mechanisms that predispose the patient to the second malignancy. These findings are particularly relevant in the management of patients with known RCC and lytic bone lesions.
Article Details
References
Kaushansky K, Lichman M, Beutler E, et al. Williams hematology. 8th ed. E book; 2010;2120.
Kaelin WG Jr. The von Hippel-Lindau tumor suppressor gene and kidney cancer. Clin Cancer Res. 2004;10:6290S–5S.
Sakai A, Kawano M, Kuramoto A. Interleukin-6 produced by renal-cell carcinoma cells and progression of multiple myeloma. N Engl J Med. 1991; 324:1893-4.
Law IP, Blom J. Second malignancies in patients with multiple myeloma. Oncology. 1977;34:20-4.
Cooper GL, Shaffer DW, Raval HB. Fine-needle aspiration biopsy of multiple myeloma in a patient with renal-cell carcinoma: A case report. Diagn Cytopathol. 1993;9:551-4.
Cielińska S, Urbaniak-Kujda D, Gabryś K, Kuliczkowski K. Coincidence of multiple myeloma and renal clear cell adenocarcinoma. Pol Arch Med Wewn. 2001;105:153-6.
Choueiri TK, Baz RC, McFadden CM, Khasawneh M, Karam MA, Kelly M, Hussein MA. An association between renal cell carcinoma and multiple myeloma: A case series and clinical implications. BJU Int. 2008;101:712-5.
Ojha RP, Evans EL, Felini MJ, Singh KP, Thertulien R. The association between renal cell carcinoma and multiple myeloma: Insights from population-based data. BJU Int. 2011;108:825-30.
Bhandari MS, Mazumder A, Jagannath S, et al. Association between renal cell carcinoma and plasma cell dyscrasia. Clin Lymphoma Myeloma. 2008;8(No 3):188–190.