Transitory Complete Response to the EpSSG Extracranial Rhabdoid Tumor Protocol in a White Adolescent with a Sickle Trait Harboring a Metastatic Renal Medullary Carcinoma

Pascal Chastagner, Romina Costanzia, Aurélie Phulpin-Weibel, Fanny Fouyssac, Godefroy deMiscault, Jacqueline Champigneulle, Ludovic Mansuy

Abstract


Renal medullary carcinoma (RMC) is a very rare disease that is almost exclusive to young black patients with sickle cell trait. Most patients present with metastatic disease at diagnosis and have a grim prognosis. Histologic diagnosis of these tumors can be difficult in the presence of rhabdoid elements and loss of INI1 expression as observed in our case. We describe the first known reported case of a white male adolescent with sickle cell trait, who was treated for a metastatic RMC with reticular pattern of rhabdoid-like cells and absence of INI1 expression, by the European Soft Tissue Sarcoma Study Group (EpSSG) protocol designed for rhabdoid tumors and who achieved a transitory complete response. Although complete remission was achieved, overall survival was not improved.

Keywords


renal tumor, rare tumors, pediatric hematology/oncology

Full Text:

PDF

References


Davis CJ, Jr., Mostofi FK, Sesterhenn IA. Renal medullary carcinoma. The seventh sickle cell nephropathy. Am J Surg Pathol 1995; 19:1-11.

Swartz MA, Karth J, Schneider DT, et al. Renal medullary carcinoma: clinical, pathologic, immunohistochemical, and genetic analysis with pathogenetic implications. Urology 2002; 60:1083-1089.

Guinan P, Sobin LH, Algaba F, et al. TNM staging of renal cell carcinoma: Workgroup No. 3. Union International Contre le Cancer (UICC) and the American Joint Committee on Cancer (AJCC). Cancer 1997; 80:992-993.

Cheng JX, Tretiakova M, Gong C, et al. Renal medullary carcinoma: rhabdoid features and the absence of INI1 expression as markers of aggressive behavior. Mod Pathol 2008; 21:647-652.

Watanabe IC, Billis A, Guimaraes MS, et al. Renal medullary carcinoma: report of seven cases from Brazil. Mod Pathol 2007; 20:914-920.

Yang XJ, Sugimura J, Tretiakova MS, et al. Gene expression profiling of renal medullary carcinoma: potential clinical relevance. Cancer 2004; 100:976-985.

Rathmell WK, Monk JP. High-dose-intensity MVAC for Advanced Renal Medullary Carcinoma: Report of Three Cases and Literature Review. Urology 2008; 72:659-663.

Walsh A, Kelly DR, Vaid YN, et al. Complete response to carboplatin, gemcitabine, and paclitaxel in a patient with advanced metastatic renal medullary carcinoma. Pediatr Blood Cancer 2010; 55:1217-1220.

Selby DM, Simon C, Foley JP, et al. Renal medullary carcinoma: can early diagnosis lead to long-term survival? J Urol 2000; 163(4):1238.

Ronnen EA, Kondagunta GV, Motzer RJ. Medullary renal carcinoma and response to therapy with bortezomib. J Clin Oncol 2006; 24, e14.




DOI: http://dx.doi.org/10.22551/2014.02.0102.10009

Copyright (c)

Creative Commons License
Archive of Clinical Cases is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

 

ISSN: 2360-6975