CC BY 4.0 · Indian J Med Paediatr Oncol 2024; 45(02): 188-193
DOI: 10.1055/s-0043-57268
Case Series

Renal Cell Carcinoma in the Background of Autosomal Dominant Polycystic Kidney Disease: Report of Two Cases and Review of Literature

Poorva Vias
1   Department of Radiotherapy & Oncology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
,
Shikha Goyal
1   Department of Radiotherapy & Oncology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
,
Renu Madan
1   Department of Radiotherapy & Oncology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
,
Nandita Kakkar
2   Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
,
Ridhi Sood
2   Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
,
Kannan Periasamy
1   Department of Radiotherapy & Oncology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
,
Rajender Kumar
3   Department of Nuclear Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
› Author Affiliations
Funding None declared.

Abstract

Patients with autosomal dominant polycystic kidney disease (ADPKD), especially those with renal failure, carry a higher risk of developing renal cell carcinoma (RCC) compared to the general population. Genetic mutations associated with ADPKD are known but a direct link associated with RCC is still controversial. We discuss the clinical course of two such patients. The first patient was diagnosed with ADPKD at the age of 10 years with an unreported tubulocystic RCC focus on his renal biopsy that was picked up on review 16 years later when he presented with vertebral metastases determined to have originated from the RCC. He was doing well on multikinase inhibitors till 4 years of diagnosis with metastatic disease when he succumbed to progressive disease after 3 lines of systemic therapy. The second patient was diagnosed with ADPKD in middle age and papillary RCC 3 years later. Within 3 months of cancer diagnosis, there was progression to metastatic disease and rapid decline despite systemic therapies. We surmise that the diagnosis of RCC may be missed in ADPKD till the advanced stages. Patients with ADPKD should be monitored regularly with imaging and biopsy if needed. Histology may be varied but once diagnosed, systemic therapies may help disease control.

Ethics Approval and Consent to Participate

Written informed consent was taken from patients at the time of treatment planning for future use as long as name was not disclosed. All ethical principles according to Helsinki guidelines were followed.


Consent for Publication

Yes, written consent to participate and publish this information was taken from the patients during the treatment.


Availability of Data and Material

Data can be made available by authors on reasonable request.


Authors' Contributions

P.V. wrote the paper and collected the data. S.G. designed the work, planned the treatment of patient and follow-up, revised and approved the final manuscript. R.M. participated in clinical decision-making, helped in writing and revision of the paper. N.K. and R.S. did the histopathological examination, made the diagnosis, and helped with pathology details for the paper. K.P. and R.K. participated in clinical decisions, and reviewed the final manuscript. All the authors read and approved the final manuscript.


Supplementary Material



Publication History

Article published online:
04 May 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 
  • References

  • 1 Torres VE, Harris PC, Pirson Y. Autosomal dominant polycystic kidney disease. Lancet 2007; 369 (9569): 1287-1301
  • 2 Barua M, Cil O, Paterson AD. et al. Family history of renal disease severity predicts the mutated gene in ADPKD. J Am Soc Nephrol 2009; 20 (08) 1833-1838
  • 3 Seeger-Nukpezah T, Geynisman DM, Nikonova AS, Benzing T, Golemis EA. The hallmarks of cancer: relevance to the pathogenesis of polycystic kidney disease. Nat Rev Nephrol 2015; 11 (09) 515-534
  • 4 Violo L, De Francesco M, Schoenholzer C. Risk of cancer in patients with polycystic kidney disease. Lancet Oncol 2016; 17 (11) e475
  • 5 Jilg CA, Drendel V, Bacher J. et al. Autosomal dominant polycystic kidney disease: prevalence of renal neoplasias in surgical kidney specimens. Nephron Clin Pract 2013; 123 (1-2): 13-21
  • 6 Hajj P, Ferlicot S, Massoud W. et al. Prevalence of renal cell carcinoma in patients with autosomal dominant polycystic kidney disease and chronic renal failure. Urology 2009; 74 (03) 631-634
  • 7 Orskov B, Sørensen VR, Feldt-Rasmussen B, Strandgaard S. Changes in causes of death and risk of cancer in Danish patients with autosomal dominant polycystic kidney disease and end-stage renal disease. Nephrol Dial Transplant 2012; 27 (04) 1607-1613
  • 8 Walters W, Braasch WF. Surgical aspects of polycystic kidney. Surg Gynecol Obstet 1934; 58: 647-650
  • 9 Keith DS, Torres VE, King BF, Zincki H, Farrow GM. Renal cell carcinoma in autosomal dominant polycystic kidney disease. J Am Soc Nephrol 1994; 4 (09) 1661-1669
  • 10 Hakozaki Y, Uchiyama K, Yanai A, Yamada D, Kamijo Y, Ishibashi Y. Sarcomatoid renal cell carcinoma with autosomal dominant polycystic kidney disease: a case report and literature review. CEN Case Rep 2021; 10 (02) 199-207
  • 11 Zeile M, Andreou D, Poellinger A, Tunn PU, Dudeck O. Identification of the primary tumour with the help of diffusion-weighted MRI in a patient with autosomal dominant polycystic kidney disease and metastatic renal cell carcinoma. Br J Radiol 2011; 84 (1003): e142-e145
  • 12 Fuser D, Hedberg ML, Dehner LP, Dehdashti F, Siegel BA. Extensive metastatic sarcomatoid renal cell carcinoma evaluated by 18F-FDG PET/CT: a case report and review of literature. J Kidney Cancer VHL 2018; 5 (01) 1-6
  • 13 Millet-Boureima C, He S, Le TBU, Gamberi C. Modeling neoplastic growth in renal cell carcinoma and polycystic kidney disease. Int J Mol Sci 2021; 22 (08) 3918
  • 14 Klingel R, Dippold W, Störkel S, Meyer zum Büschenfelde KH, Köhler H. Expression of differentiation antigens and growth-related genes in normal kidney, autosomal dominant polycystic kidney disease, and renal cell carcinoma. Am J Kidney Dis 1992; 19 (01) 22-30
  • 15 Nishimura H, Ubara Y, Nakamura M. et al. Renal cell carcinoma in autosomal dominant polycystic kidney disease. Am J Kidney Dis 2009; 54 (01) 165-168
  • 16 Na KY, Kim HS, Park YK, Chang SG, Kim YW. Multifocal renal cell carcinoma of different histological subtypes in autosomal dominant polycystic kidney disease. Korean J Pathol 2012; 46 (04) 382-386
  • 17 Ibrahim S. Increased apoptosis and proliferative capacity are early events in cyst formation in autosomal-dominant, polycystic kidney disease. ScientificWorldJournal 2007; 7: 1757-1767
  • 18 Edge SB, Byrd DR, Compton CC. et al, eds. AJCC Cancer Staging Manual. 7th ed. New York: Springer; 2010
  • 19 Moch H, Cubilla AL, Humphrey PA, Reuter VE, Ulbright TM. The 2016 WHO classification of tumours of the urinary system and male genital organs-part a: renal, penile, and testicular tumours. Eur Urol 2016; 70 (01) 93-105
  • 20 Cimadamore A, Cheng L, Scarpelli M. et al. Towards a new WHO classification of renal cell tumor: what the clinician needs to know - a narrative review. Transl Androl Urol 2021; 10: 1506-1520
  • 21 Kimura Y, Funahashi Y, Kato M, Fujita T, Tsuruta K, Gotoh M. Metastatic tubulocystic renal cell carcinoma treated with targeted therapies. J Urol Res. 2014; 1: 1013
  • 22 Sun X, Gan L, Na A, Ge L, Chen B, Liu J. Combination with stereotactic body radiotherapy offers a promising strategy to overcome resistance to immunotherapy in advanced renal cell cancer. J Oncol 2019; 2019: 1483406
  • 23 Thummala Y, Parmar K, Mathew J, Tyagi S, Kumar S. Bilateral laparoscopic nephrectomy in autosomal dominant polycystic kidney disease with bilateral renal masses: a feasible option. J Endourol Case Rep 2020; 6 (04) 353-357
  • 24 Huh H, Jo HA, Yi Y. et al. Xp11.2 translocation renal cell carcinoma in the autosomal dominant polycystic kidney disease patient with preserved renal function. Korean J Intern Med (Korean Assoc Intern Med) 2017; 32 (06) 1108-1111
  • 25 Soderdahl DW, Thrasher JB, Hansberry KL. Bilateral renal cell carcinoma in autosomal dominant polycystic kidney disease. A case report and literature review. Am J Nephrol 1997; 17 (01) 96-99
  • 26 Xu L, Rong Y, Wang W. et al. Percutaneous radiofrequency ablation with contrast-enhanced ultrasonography for solitary and sporadic renal cell carcinoma in patients with autosomal dominant polycystic kidney disease. World J Surg Oncol 2016; 14 (01) 193
  • 27 Kanesvaran R, Porta C, Wong A. et al. Pan-Asian adapted ESMO Clinical Practice Guidelines for the diagnosis, treatment and follow-up of patients with renal cell carcinoma. ESMO Open 2021; 6 (06) 100304
  • 28 Lieberthal W, Levine JS. The role of the mammalian target of rapamycin (mTOR) in renal disease. J Am Soc Nephrol 2009; 20 (12) 2493-2502
  • 29 Canaud G, Knebelmann B, Harris PC. et al. Therapeutic mTOR inhibition in autosomal dominant polycystic kidney disease: what is the appropriate serum level?. Am J Transplant 2010; 10 (07) 1701-1706
  • 30 Harshman LC, Kroeger N, Rha SY. et al. First-line mammalian target of rapamycin inhibition in metastatic renal cell carcinoma: an analysis of practice patterns from the International Metastatic Renal Cell Carcinoma Database Consortium. Clin Genitourin Cancer 2014; 12 (05) 335-340