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Ochsner J. 2014 Summer;14(2):270-5.

Renal medullary carcinoma: a case report and brief review of the literature.

Author information

1
Department of Genitourinary Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX.
2
Department of Hematology and Oncology, Ochsner Clinic Foundation, New Orleans, LA.

Abstract

BACKGROUND:

Renal medullary carcinoma (RMC) is an aggressive form of non-clear cell kidney cancer that typically affects young adults and is almost exclusively associated with sickle cell trait. Typical RMC patients tend to be young black males (2:1 male to female predominance) with sickle cell trait who present with pain and hematuria and are found to have metastatic disease at diagnosis. Prognosis is extremely poor, with a mean survival of less than a year in most cases.

CASE REPORT:

We present a case illustrative of many of the classic findings of RMC. A 25-year-old female with a past medical history of sickle cell trait presented to the emergency room with right-sided flank pain. Initially, a computed tomography (CT) scan showed only a benign-appearing cystic lesion 4.5 cm in diameter in the right kidney. Six months later, the patient re-presented with hematuria, lightheadedness, and dizziness. A repeat CT scan showed that the renal cyst had enlarged to 5.6 cm. The patient underwent a decortication and fulguration procedure that revealed malignancy in the wall of the cyst. She was given a series of treatments but experienced progressive disease and passed away 2 years and 8 months after metastatic diagnosis.

CONCLUSION:

Neither systemic therapy nor radiation therapy has been found to be particularly efficacious in the treatment of RMC. As the underlying biologic mechanisms of RMC are further elucidated on a basic science level, we expect new translational research opportunities will emerge and novel treatment options will be developed for this rare and dismal disease.

KEYWORDS:

Carcinoma–renal cell; kidney neoplasms; sickle cell trait

PMID:
24940141
PMCID:
PMC4052598

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