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. 2013 Jan;1(1):112-116.
doi: 10.3892/mco.2012.5. Epub 2012 Aug 3.

Successful treatment of erythropoietin-producing advanced renal cell carcinoma after targeted therapy using sunitinib: Case report and review of the literature

Kosuke Ueda  1 , Shigetaka Suekane  1 , Katsuaki Chikui  1 , Makoto Nakiri  1 , Fukuko Moriya  1 , Tokumasa Hayashi  1 , Jiro Miyajima  1 , Kei Matsuoka  1
Affiliations

Successful treatment of erythropoietin-producing advanced renal cell carcinoma after targeted therapy using sunitinib: Case report and review of the literature

Kosuke Ueda et al. Mol Clin Oncol. 2013 Jan.

Abstract

In general, only ≤5% of patients with renal cell carcinoma (RCC) develop paraneoplastic erythropoietin (EPO) overproduction-induced polycythemia. However, a number of reports on EPO-producing RCC are available. The present study aimed to report the first case of a patient demonstrating a therapeutic effect on EPO-producing advanced RCC, subsequent to targeted pre-surgical sunitinib therapy, with a review of the literature. The patient involved was a 62-year-old male who presented with a malformation of the left scrotum. Examination revealed a tumor of 73 mm in diameter along with lymph node metastasis. The histological examination indicated a clear cell RCC containing viable cells as well as hemorrhage and necrosis. EPO in cancer cells was confirmed by immunohistochemistry. Subsequently, a case of EPO-producing RCC with polycythemia was diagnosed. The EPO-producing RCC was successfully treated following targeted presurgical therapy with sunitinib.

Keywords: erythropoietin; polycythemia; renal cell carcinoma; sunitinib.

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Figures

Figure 1
Figure 1
CT scan at diagnosis. Abdominal CT revealed (A) a 73-mm diameter heterogeneously enhanced mass at the upper pole of the left kidney with (B) embolism in the renal vein and inferior vena cava.
Figure 2
Figure 2
Microscopic appearance of the tumor biopsy specimen showed a clear cell renal cell carcinoma, which proliferated in an alveolar pattern.
Figure 3
Figure 3
Microscopic appearance of tissue slides from the renal tumor is shown. Histological examination of the tumor showed clear cell renal cell carcinoma. Although most of the tumor had viable cells, hemorrhage and necrosis were present. (H&E; magnification, ×100).
Figure 4
Figure 4
(A) Immunohistochemical staining with erythropoietin (EPO) showed that the cytoplasm of tumor cells was diffuse-positive. (B) Normal kidney tissues were diffuse-negative.
Figure 5
Figure 5
Pre- and post-treatment serum hemoglobin (Hb) and hematocrit (Ht) levels are shown.
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