Acquired cystic disease and renal cell carcinoma in hemodialysis patients – A case report on three patients

  • Mirjana Mijušković Clinic of Nephrology, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
  • Novak Milović Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia; Clinic of Urology, Military Medical Academy, Belgrade, Serbia
  • Božidar Kovačević Institute of Pathology, Military Medical Academy, Belgrade, Serbia
  • Dragan Jovanović Clinic of Nephrology, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
  • Dara Stefanović Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia; Institute of Radiology, Military Medical Academy, Belgrade, Serbia
  • Ljiljana Ignjatović Clinic of Nephrology, Military Medical Academy, Belgrade, Serbia
  • Brankica Terzić Clinic of Nephrology, Military Medical Academy, Belgrade, Serbia
  • Jelena Tadić Pilčević Clinic of Nephrology, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
  • Marijana Petrović Clinic of Nephrology, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
  • Dejan Pilčević Clinic of Nephrology, Military Medical Academy, Belgrade, Serbia
  • Kataina Obrenčević Centar for Solid Organ Transplantation, Military Medical Academy, Belgrade, Serbia
  • Snežana Cerović Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia; Institute of Pathology, Military Medical Academy, Belgrade, Serbia
DOI: https://doi.org/10.2298/5656
Keywords: renal dialysis, kidney diseases, cystic, hemodyalisis, nephrectomy, treatment outcome,

Abstract


Introduction. Renal cell carcinoma (RCC) is derived from renal tubular epithelial cells and represents approximately 3.8% of all malignancies in adults. The incidence of renal cell carcinoma has been growing steadily and ranging from 0.6 to 14.7 for every 100,000 inhabitants. Patients with end-stage renal disease and acquired cystic kidney disease are at increased risk of developing RCC while undergoing dialysis treatment or after renal transplantation. Case report. We presented 3 patients undergoing hemodialysis, with acquired cystic kidney disease accompanied by the development of RCC. In all the patients tumor was asymptomatic and discovered through ultrasound screening in 2 patients and in 1 of the patients by post-surgery pathohistological analysis of the tissue of the kidney excised using nephrectomy. All the three patients had organ-limited disease at the time of the diagnosis and they did not require additional therapy after surgical treatment. During the follow-up after nephrectomy from 6 months to 7 years, local recurrence or metastasis of RCC were not diagnosed. Conclusion. Acquired cystic kidney disease represents a predisposing factor for the development of renal cell carcinoma in dialysis patients and requires regular ultrasound examinations of the abdomen aimed at early diagnosis of malignancies. Prognosis for patients with end-stage renal disease and RCC is mostly good because these tumors are usually of indolent course.

References

NCI - National Cancer Institute. SEER Cancer Statistics Review, 1975–2011.

Available from: http://seer.cancer.gov/statfacts/html/kidrp.html

Goh A, Vathsala A. Native renal cysts and dialysis duration are risk factors for renal cell carcinoma in renal transplant recipients. Am J Transplant 2011; 11(1): 86−92.

Russo P. End stage and chronic kidney disease: associations with renal cancer. Front Oncol 2012; 28(2): 1−7.

Schwarz A, Vatandaslar S, Merkel S, Haller H. Renal cell carcinoma in transplant recipients with acquired cystic kidney disease. Clin J Am Soc Nephrol 2007; 2(4): 750−6.

Truong LD, Krishnan B, Cao JT, Barrios R, Suki WN. Renal neop-lasm in acquired cystic kidney disease. Am J Kidney Dis 1995; 26(1): 1−12.

Faure V, Cerini C, Paul P, Berland Y, Dignat-George F, Brunet P. The uremic solute p-cresol decreases leukocyte transendothelial migration in vitro. Int Immunol 2006; 18(10): 1453−9.

Stengel B. Chronic kidney disease and cancer: a troubling connection. J Nephrol 2010; 23(3): 253−62.

Katabathina VS, Kota G, Dasyam AK, Shanbhogue AK, Prasad SR. Adult renal cystic disease: a genetic, biological, and developmental primer. Radiographics 2010; 30(6): 1509−23.

Bhatnagar R, Alexiev BA. Renal-cell carcinomas in end-stage kidneys: a clinicopathological study with emphasis on clear-cell papillary renal-cell carcinoma and acquired cystic kidney disease-associated carcinoma. Int J Surg Pathol 2012; 20(1): 19−28.

Neuzillet Y, Tillou X, Mathieu R, Long J, Gigante M, Paparel P, et al. Renal cell carcinoma (RCC) in patients with end-stage renal disease exhibits many favourable clinical, pathologic, and outcome features compared with RCC in the general population. Eur Urol 2011; 60(2): 366−73.

Ljungberg B, Bensalah K, Bex A, Canfield S, Dabestani S, Hofmann F, et al. Guidelines on Renal Cell Carcinoma: Europeon Association of Urology 2013 [accessed2013 August 20]. Available from: http://www.uroweb.org/gls/pdf/10_Renal_Cell_Carcinoma_LR.pdf.

Dunnill MS, Millard PR, Oliver D. Acquired cystic disease of the kidneys: a hazard of long-term intermittent maintenance haemodialysis. J Clin Pathol 1977; 30(9): 868−77.

Matson MA, Cohen EP. Acquired cystic kidney disease: occurrence, prevalence, and renal cancers. Medicine (Baltimore) 1990; 69(4): 217−26.

Kojima Y, Takahara S, Miyake O, Nonomura N, Morimoto A, Mori H. Renal cell carcinoma in dialysis patients: a single center experience. Int J Urol 2006; 13(8): 1045−8.

Lee HH, Choi KH, Yang SC, Han WK. Renal cell carcinoma in kidney transplant recipients and dialysis patients. Korean J Urol 2012; 53(4): 229−33.

Peces R, Martínez-Ara J, Miguel JL, Arrieta J, Costero O, Górriz JL, et al. Renal cell carcinoma co-existent with other renal disease: clinico-pathological features in pre-dialysis patients and those receiving dialysis or renal transplantation. Nephrol Dial Transplant 2004; 19(11): 2789−96.

Wolters U, Wolf T, Stützer H, Schröder T. ASA classification and perioperative variables as predictors of postoperative outcome. Br J Anaesth 1996; 77(2): 217−22.

Correas JM, Joly D, Chauveau D, Richard S, Hélénon O. Renal failure and cystic kidney diseases. J Radiol 2011; 92(4): 308−22.

Kuroda N, Ohe C, Mikami S, Hes O, Michal M, Brunelli M, et al. Review of acquired cystic disease-associated renal cell carcinoma with focus on pathobiological aspects. Histol Histopathol 2011; 26(9): 1215−8.

Sassa N, Hattori R, Tsuzuki T, Watarai Y, Fukatsu A, Katsuno S, et al. Renal cell carcinomas in haemodialysis patients: does haemodialysis duration influence pathological cell types and prognosis. Nephrol Dial Transplant 2011; 26(5): 1677−82.

Srigley JR, Delahunt B, Eble JN, Egevad L, Epstein JI, Grignon D, et al. The International Society of Urological Pathology (ISUP) Vancouver Classification of Renal Neoplasia. Am J Surg Pathol 2013; 37(10): 1469−89.

Bostwick DG, Cheng L. Urologic Surgical Pathology. 2nd ed. Philadelphia, PA: Mosby Elsevier; 2008.

Borràs M, Valdivielso JM, Egido R, de Vicente VP, Bordalba JR, Fernández E. Haemoperitoneum caused by bilateral renal cyst rupture in an ACKD peritoneal dialysis patient. Nephrol Dial Transplant 2006; 21(3): 789−91.

Ghasemian S, Pedraza R, Sasaki TA, Light JA, Patel SV. Bilateral laparoscopic radical nephrectomy for renal tumors in patients with acquired cystic kidney disease. J Laparoendosc Adv Surg Tech A 2005; 15(6): 606−10.

Research Update: Cancer in Lupus. (Based on presentation by Dr. Sasha Bernatsky at BC Lupus Society Symposium.) [cited 2005 October 22].

Available from: <http://www.bclupus.org/resources.html>.

Sultan SM, Ioannou Y, Isenberg DA. Is there an association of malignancy with systemic lupus erythematosus? An analysis of 276 patients under long-term review. Rheumatology 2000; 39(10): 1147−52.

Gopalakrishnan G, Nampoory NM, Ali JH, Johny KV. Renal cell carcinoma in a patient with systemic lupus erythematosus: A case report. Med Principles Pract 1996; 5(3): 160−2.

Wong G, Hayen A, Chapman JR, Webster AC, Wang JJ, Mitchell P, et al. Association of CKD and cancer risk in older people. J Am Soc Nephrol 2009; 20(6): 1341−50.

Weng P, Hung K, Huang H, Chen J, Sung P, Huang K. Cancer-specific mortality in chronic kidney disease: longitudinal follow-up of a large cohort. Clin J Am Soc Nephrol 2011; 6(5): 1121−8.

Published
2015/11/02
Issue
Vol. 72 No. 10 (2015)
Section
Case report