Renal cell carcinoma presenting as Henoch-Schönlein purpura with leukocytoclastic vasculitis, hematuria, proteinuria and abdominal pain.
Some infectious, rheumatic, allergic diseases, and malignancies have been associated with leucocytoclastic vasculitis (LCV). LCV and cancer occur most frequently in patients with hematological malignancies such as lymphomas and leukemias. There have been a few prior cases reported of LCV associated with renal cell carcinoma (RCC). A 25-year-old male patient was referred from the department of dermatology and nephrology because of recurrent petechiae on both lower legs for several months; the patient also had a tumor of the left kidney. The findings on the skin biopsy were compatible with the diagnosis of LCV. The patient was diagnosed as having Henoch-Schönlein purpura (HSP) with LCV. A CT scan performed due to abdominal pain revealed a mass on the upper pole of the left kidney. A partial nephrectomy of the left kidney including the tumor was performed. The pathology report was consistent with a clear cell type of renal cell carcinoma, Fuhrman's grade 2; the tumor measured 0.9 x 0.8 cm and focal segmental glomerulosclerosis was noted in non-neoplastic regions. Here, we report a case of LCV associated with RCC presenting as HSP. This case illustrates the importance of evaluating patients for an underlying malignancy when HSP or LCV is diagnosed.
Hong
Young Hoon
YH
Division of Rheumatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea. yhhong@med.yu.ac.kr
D015746:Abdominal Pain / Q000150:complications / Q000473:pathology*; D000328:Adult; D002292:Carcinoma, Renal Cell / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D003937:Diagnosis, Differential; D006417:Hematuria / Q000150:complications / Q000473:pathology*; D006801:Humans; D011695:IgA Vasculitis / Q000150:complications / Q000175:diagnosis*; D007680:Kidney Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D008297:Male; D009392:Nephrectomy; D011507:Proteinuria / Q000150:complications / Q000473:pathology*; D018366:Vasculitis, Leukocytoclastic, Cutaneous / Q000150:complications / Q000473:pathology*