Clear Cell RCC with Lytic Bony Lesions: Metastasis or Multiple Myeloma, A Diagnostic Dilemna

Main Article Content

Anuj Mahajan
Prashanth Adiga
Janine Miranda

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.

Keywords:
Lytic bone lesions in RCC, coexistant malignancies, multiple myeloma.

Article Details

How to Cite
Mahajan, A., Adiga, P., & Miranda, J. (2020). Clear Cell RCC with Lytic Bony Lesions: Metastasis or Multiple Myeloma, A Diagnostic Dilemna. Asian Journal of Research and Reports in Urology, 3(4), 23-27. Retrieved from https://journalajrru.com/index.php/AJRRU/article/view/30118
Section
Case Report

References

Munchi N, Longo D, Anderson K, Kasper D, Fauci A, Hauser S, et al. Harrison principles of internal medicine. 19th ed. Mc Graw Hill Pub; Plasma cell disorders; Mc Graw Hill pub; 2015.

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.