Focal Segmental Glomerulosclerosis Preceding Type 2 Papillary Renal Cell Carcinoma
Renal cell carcinoma (RCC) is the predominant renal malignancy in adults. Of the four general subtypes, papillary renal cell carcinoma (P-RCC) is the second most common and can be subdivided into type I, type II, and a mixture of type I and II. Focal segmental glomerulosclerosis (FSGS) is the most c...
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Wiley
2020-01-01
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| Series: | Case Reports in Pathology |
| Online Access: | http://dx.doi.org/10.1155/2020/8811905 |
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| author | Dominik Dabrowski Ekin Ozluk Silvia Barbeito Eric X. Wei |
| author_facet | Dominik Dabrowski Ekin Ozluk Silvia Barbeito Eric X. Wei |
| author_sort | Dominik Dabrowski |
| collection | DOAJ |
| description | Renal cell carcinoma (RCC) is the predominant renal malignancy in adults. Of the four general subtypes, papillary renal cell carcinoma (P-RCC) is the second most common and can be subdivided into type I, type II, and a mixture of type I and II. Focal segmental glomerulosclerosis (FSGS) is the most common glomerulopathy at all ages, and it can be seen as a paraneoplastic syndrome. RCC, in general, is known to present with many paraneoplastic syndromes, and glomerulopathies are among these. Rarely, RCC and glomerulopathies may overlap in the same patient. Here, we report a 58-year-old male with a past medical history of FSGS and chronic kidney disease (CKD), stage III, who was found to have an incidental renal mass that was later diagnosed as type II P-RCC. The histology showed pseudostratified tumor cells with an eosinophilic cytoplasm that formed papillary configurations and displayed areas of necrosis. The prior FSGS diagnosis exhibited segmental sclerosis, refractory tufts, and capillary membrane wrinkling. A period of 1.5 years elapsed between the diagnosis of the glomerulopathy and the malignancy. The tumor was found to be at stage TIb. To our knowledge, this may be the first reported case of usual-type FSGS as paraneoplastic glomerulopathy (PG) preceding P-RCC. Because FSGS only sparingly affects the kidney and is a common glomerulopathy in adults, it is reasonable to complete comprehensive diagnostic studies and commence medically necessary treatment, especially in the background of other renal comorbidities. These preexisting comorbidities may be associated with malignancy very early in its course. The probability of RCC-associated paraneoplastic glomerulopathy is low, which means an already incidentally found renal mass may conceal a serpentine paraneoplastic syndrome. A more developed understanding of these manifestations can lead experienced clinicians to suspect and possibly uncover an insidious RCC before it advances. |
| format | Article |
| id | doaj-art-0842e99e7b4f4e16b2859b20179fb15c |
| institution | Kabale University |
| issn | 2090-6781 2090-679X |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Pathology |
| spelling | doaj-art-0842e99e7b4f4e16b2859b20179fb15c2025-02-03T05:51:16ZengWileyCase Reports in Pathology2090-67812090-679X2020-01-01202010.1155/2020/88119058811905Focal Segmental Glomerulosclerosis Preceding Type 2 Papillary Renal Cell CarcinomaDominik Dabrowski0Ekin Ozluk1Silvia Barbeito2Eric X. Wei3Department of Pathology and Translational Pathobiology, LSU Health Shreveport, USADepartment of Pathology and Translational Pathobiology, LSU Health Shreveport, USADepartment of Radiology, LSU Health Shreveport, USADepartment of Pathology and Translational Pathobiology, LSU Health Shreveport, USARenal cell carcinoma (RCC) is the predominant renal malignancy in adults. Of the four general subtypes, papillary renal cell carcinoma (P-RCC) is the second most common and can be subdivided into type I, type II, and a mixture of type I and II. Focal segmental glomerulosclerosis (FSGS) is the most common glomerulopathy at all ages, and it can be seen as a paraneoplastic syndrome. RCC, in general, is known to present with many paraneoplastic syndromes, and glomerulopathies are among these. Rarely, RCC and glomerulopathies may overlap in the same patient. Here, we report a 58-year-old male with a past medical history of FSGS and chronic kidney disease (CKD), stage III, who was found to have an incidental renal mass that was later diagnosed as type II P-RCC. The histology showed pseudostratified tumor cells with an eosinophilic cytoplasm that formed papillary configurations and displayed areas of necrosis. The prior FSGS diagnosis exhibited segmental sclerosis, refractory tufts, and capillary membrane wrinkling. A period of 1.5 years elapsed between the diagnosis of the glomerulopathy and the malignancy. The tumor was found to be at stage TIb. To our knowledge, this may be the first reported case of usual-type FSGS as paraneoplastic glomerulopathy (PG) preceding P-RCC. Because FSGS only sparingly affects the kidney and is a common glomerulopathy in adults, it is reasonable to complete comprehensive diagnostic studies and commence medically necessary treatment, especially in the background of other renal comorbidities. These preexisting comorbidities may be associated with malignancy very early in its course. The probability of RCC-associated paraneoplastic glomerulopathy is low, which means an already incidentally found renal mass may conceal a serpentine paraneoplastic syndrome. A more developed understanding of these manifestations can lead experienced clinicians to suspect and possibly uncover an insidious RCC before it advances.http://dx.doi.org/10.1155/2020/8811905 |
| spellingShingle | Dominik Dabrowski Ekin Ozluk Silvia Barbeito Eric X. Wei Focal Segmental Glomerulosclerosis Preceding Type 2 Papillary Renal Cell Carcinoma Case Reports in Pathology |
| title | Focal Segmental Glomerulosclerosis Preceding Type 2 Papillary Renal Cell Carcinoma |
| title_full | Focal Segmental Glomerulosclerosis Preceding Type 2 Papillary Renal Cell Carcinoma |
| title_fullStr | Focal Segmental Glomerulosclerosis Preceding Type 2 Papillary Renal Cell Carcinoma |
| title_full_unstemmed | Focal Segmental Glomerulosclerosis Preceding Type 2 Papillary Renal Cell Carcinoma |
| title_short | Focal Segmental Glomerulosclerosis Preceding Type 2 Papillary Renal Cell Carcinoma |
| title_sort | focal segmental glomerulosclerosis preceding type 2 papillary renal cell carcinoma |
| url | http://dx.doi.org/10.1155/2020/8811905 |
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