Secondary renal neoplasia following chemotherapy or radiation in pediatric patients Journal Article


Authors: Gupta, S.; Vanderbilt, C. M.; Leibovich, B. C.; Herrera-Hernandez, L.; Raghunathan, A.; Sukov, W. R.; Voss, J. S.; Barr Fritcher, E. G.; Reed, K. A.; Lohse, C. M.; Reuter, V. E.; Jimenez, R. E.; Thompson, R. H.; Cheville, J. C.
Article Title: Secondary renal neoplasia following chemotherapy or radiation in pediatric patients
Abstract: Renal neoplasia occurring as a second malignancy following childhood cancer has been most closely associated with neuroblastoma and Wilms tumor. While some cases have been associated with a genetic predisposition, nearly all are thought to result from “late effects” of therapy-related toxicity that involves chemotherapy or radiation. It is unclear if these tumors are enriched for specific molecular or morphologic characteristics. A query of our institutional nephrectomy registry of 8295 patients for renal neoplasia occurring post-treatment for childhood cancer revealed 6 patients with Wilms tumor, 4 with neuroblastoma, and 1 with acute lymphoblastic leukemia (ALL). Three additional cases of MiT family translocation renal cell carcinoma (RCC), from 2 patients, following chemotherapy for neuroblastoma and systemic lupus erythematosus and another of clear cell RCC post-ALL were included. The most common tumor type was clear cell RCC: 9/19 cases (47.4%), followed by metanephric adenoma and MiT family translocation RCC (3/19, 15.8%). There were no characteristic features to indicate a unique renal neoplasia subtype. Potential syndromic renal neoplasia occurred in 2 patients, metanephric adenomas and oncocytoma in a patient with hyperparathyroidism-jaw tumor syndrome post-treatment of Wilms tumor and a fumarate hydratase-deficient RCC in a patient post-treatment for ALL. The mean age at diagnosis of childhood neoplasia or treatment with chemotherapy or radiation was 4.7 years, and the average time to subsequent renal neoplasia was 31 years. Five (of 14) patients developed metastatic RCC, and there were 2 RCC-related deaths. These results indicate the need for extended clinical follow-up of these patients. © 2020 Elsevier Inc.
Keywords: immunohistochemistry; cancer chemotherapy; child; clinical article; preschool child; clinical feature; histopathology; cancer radiotherapy; chemotherapy; antineoplastic agent; cancer diagnosis; gene; radiation; cytogenetics; oncocytoma; renal cell carcinoma; acute lymphoblastic leukemia; childhood cancer; gene rearrangement; kidney tumor; neuroblastoma; hyperparathyroidism; immunophenotyping; systemic lupus erythematosus; second cancer; nephroblastoma; tfe3 gene; tfeb gene; wilms tumor; high throughput sequencing; human; article; rna sequencing; jaw tumor; pediatric patient
Journal Title: Human Pathology
Volume: 103
ISSN: 0046-8177
Publisher: Elsevier Inc.  
Date Published: 2020-09-01
Start Page: 1
End Page: 13
Language: English
DOI: 10.1016/j.humpath.2020.07.014
PUBMED: 32681944
PROVIDER: scopus
PMCID: PMC8935764
DOI/URL:
Notes: Article -- Export Date: 1 September 2020 -- Source: Scopus
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  1. Victor Reuter
    1223 Reuter