Rectal cancer with paraneoplastic nephropathy: association of vascular endothelial growth factor.
A patient with advanced rectal cancer was complicated by progressing proteinuria and hypoproteinemia. Low anterior resection was a procedure of choice. A surgical specimen obtained by intraoperative renal biopsy showed the findings of minimal change nephrotic syndrome. After surgery, nephropathy remitted promptly and completely. Her pre/postoperative serum level of vascular endothelial growth factor was 1,880/52.3 pg/ml, suggesting its elevation was associated with the nephropathy. Immunohistochemistry revealed strongly expressed tumor vascular endothelial cell growth factor. Minimal change nephrotic syndrome is a rare type of paraneoplastic nephropathy, and successful remission may require therapeutic resection of the underlying tumor, or administration of a vascular endothelial growth factor antagonist if the tumor is unresectable.
Taniguchi
Ken
K
Department of Surgery, National Nagasaki Medical Center Clinical Research Center, Nagasaki, Japan. kmtani@bekkoame.ne.jp
Fujioka
Hikaru
H
Torashima
Yasuhiro
Y
Yamaguchi
Junzo
J
Izawa
Kunihide
K
Kanematsu
Takashi
T
D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D009402:Nephrosis, Lipoid / Q000453:epidemiology / Q000378:metabolism / Q000503:physiopathology* / Q000601:surgery*; D010257:Paraneoplastic Syndromes / Q000378:metabolism / Q000503:physiopathology* / Q000601:surgery*; D012004:Rectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology* / Q000601:surgery; D042461:Vascular Endothelial Growth Factor A / Q000097:blood / Q000378:metabolism / Q000502:physiology*
D042461:Vascular Endothelial Growth Factor A