Renal medullary-like carcinoma in an adult without sickle cell hemoglobinopathy Journal Article


Authors: O'Donnell, P. H.; Jensen, A.; Posadas, E. M.; Bridge, J. A.; Yeldandi, A. V.; Yang, X. J.; Stadler, W. M.; Al-Ahmadie, H.
Article Title: Renal medullary-like carcinoma in an adult without sickle cell hemoglobinopathy
Abstract: Background. A 42-year-old white man with no significant prior medical history presented with macroscopic hematuria of 2 months' duration. His family history was notable for a maternal grandfather with kidney cancer. Investigations. Urinalysis, CT, microscopic examination of tumor, immunohistochemical analysis of tumor, hemoglobin electrophoresis, molecular cytogenetic analysis, gene sequencing.Diagnosis. Renal medullary-like carcinoma in an adult without sickle cell trait, sickle cell disease or other hemoglobinopathies.Management. The patient underwent laparoscopic nephrectomy to remove the tumor and received adjuvant sorafenib (400mg per day) as part of the E2805 ASSURE (Adjuvant Sorafenib or Sunitinib for Unfavorable Renal Carcinoma) trial. Metastatic recurrence of the tumor occurred 9 months after nephrectomy, for which the patient underwent tumor debulking and retroperitoneal lymph node dissection, followed by chemotherapy consisting of gemcitabine (2,000 mg/m 2) and doxorubicin (50 mg/m2), both given on day 1 of a 14-day cycle. After six cycles of drug treatment, the patient had achieved a partial response. The patient was managed by active surveillance for 4 months, when he developed further symptoms and disease progression was detected. Third-line systemic therapy in the form of 21-day cycles of cisplatin (80 mg/m2 on day 1) and etoposide (100 mg/m2 on days 1-3) has recently been initiated. © 2010 Macmillan Publishers Limited. All rights reserved.
Keywords: immunohistochemistry; adult; splenectomy; case report; sorafenib; cisplatin; doxorubicin; sunitinib; cancer growth; gemcitabine; adjuvant therapy; lymph node metastasis; lymph node dissection; paraaortic lymph node; computer assisted tomography; multiple cycle treatment; etoposide; hematuria; kidney carcinoma; kidney neoplasms; nephrectomy; backache; carcinoma, renal cell; family history; cytokeratin 7; kidney cancer; chromosome analysis; electrophoresis; renal medullary carcinoma; kidney medulla; keratin; hemoglobin sc disease; anemia, sickle cell; hemoglobinopathies
Journal Title: Nature Reviews Urology
Volume: 7
Issue: 2
ISSN: 1759-4812
Publisher: Nature Publishing Group  
Date Published: 2010-02-01
Start Page: 110
End Page: 114
Language: English
DOI: 10.1038/nrurol.2009.255
PUBMED: 20145663
PROVIDER: scopus
DOI/URL:
Notes: --- - "Export Date: 20 April 2011" - "Source: Scopus"
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