Concurrent renal cell carcinoma and central nervous system lymphoma in a patient with autosomal dominant polycystic kidney disease.
OBJECTIVE
To report an unusual case of synchronous renal cell carcinoma and CNS lymphoma in a patient with autosomal dominant polycystic kidney disease (ADPKD).


METHODS
A 58-year-old woman presented with progressive right hemiparesis of 2 months' duration. A brain CT scan revealed multiple enhanced lesions in the basal ganglia and the right occipital lobe. CNS lymphoma was confirmed by a stereotactic biopsy. Polycystic kidneys and a right renal mass were found incidentally. It was decided to treat the patient with cranial radiotherapy and chemotherapy first. The patient achieved complete remission of CNS lymphoma after 3 months, but the renal mass remained unchanged. A needle biopsy of the renal mass revealed renal cell carcinoma and unilateral nephrectomy was performed successfully. The patient remained in complete remission at 6-year follow-up.


CONCLUSIONS
The patient was treated successfully with a combination of chemotherapy, radiotherapy, and unilateral nephrectomy. This report highlights the need for clinicians to remain alert to the possibility of double malignancies while caring for ADPKD patients, especially when multiple unexplained manifestations exist.
Chang
Ming-Yang
MY
Department of Nephrology, Kidney Research Center, Chang Gung Memorial Hospital, Chang Gung University, Kueishan, Taoyuan 333 Taiwan. mingyc@adm.cgmh.org.tw
Chen
Yu-Ming
YM
Chen
Yung-Cheng
YC
Tian
Ya-Chung
YC
Fang
Ji-Tseng
JT
Yang
Chih-Wei
CW
D002292:Carcinoma, Renal Cell / Q000150:complications* / Q000473:pathology; D016543:Central Nervous System Neoplasms / Q000150:complications* / Q000473:pathology; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000150:complications* / Q000473:pathology; D008223:Lymphoma / Q000150:complications* / Q000473:pathology; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000473:pathology; D016891:Polycystic Kidney, Autosomal Dominant / Q000150:complications*