Current issue
Journal content
Articles in press
Archive
About the Journal
About the Polish Annals of Medicine
Editorial Board
Abstracting & indexing
Open Access policy
Charges
Affiliated institutions
Contact
Instructions
Peer review process
Guide for authors
Publication ethics
Ethics and Patient Consent
User License
Usage of third party materials
Disclaimer
Statement on Artificial Intelligence
Reviewers
Guide for reviewers
Review Form
CASE REPORT
Renal cell carcinoma with alpha-fetoprotein secretion and tissue expression – A case report
1
Clinical Department of Oncology and Immunooncology, Ministry of Internal Affairs Hospital with Warmia and Mazury Oncology Centre in Olsztyn, Poland
2
Chair and Department of Pathomorphology, Faculty of Medicine, Medical University of Gdańsk, Poland
3
Department of Oncology, NZOZ Magodent, Warsaw, Poland
4
Department of Oncology, Faculty of Medical Sciences, University of Warmia and Mazury in Olsztyn, Poland
5
Department of Diagnostic Imaging, Ministry of Internal Affairs Hospital with Warmia and Mazury Oncology Centre in Olsztyn, Poland
6
Department of Pathology and Neuropathology, Medical University of Gdańsk, Department of Pathomorphology, Copernicus PL Hospitals, Poland
Submission date: 2016-01-25
Acceptance date: 2016-11-24
Online publication date: 2016-12-14
Publication date: 2020-03-22
Corresponding author
Dawid Sigorski
Clinical Department of Oncology and Immunooncology, Ministry of Internal Affairs Hospital with Warmia and Mazury Oncology Centre in Olsztyn, Wojska Polskiego 37, 10-228 Olsztyn, Poland. Tel.: +48 89 539 8515; fax: +48 89 539 8303.
Clinical Department of Oncology and Immunooncology, Ministry of Internal Affairs Hospital with Warmia and Mazury Oncology Centre in Olsztyn, Wojska Polskiego 37, 10-228 Olsztyn, Poland. Tel.: +48 89 539 8515; fax: +48 89 539 8303.
Pol. Ann. Med. 2017;24(2):240-244
KEYWORDS
ABSTRACT
Introduction:
Alpha-fetoprotein (AFP) is a glycoprotein which can be elevated in some nononcological conditions, and in few types of cancers being a diagnostic and monitoring biomarker. Kidney cancer can produce several substances, which have biological activity and even cause paraneoplastic syndromes. AFP elevation in course of renal cancer is extremely rarely encountered.
Aim:
To present diagnostic difficulties in a case of a 43-year-old man with a kidney tumor.
Case study:
Clinical and pathological case description.
Results and discussion:
The patient initially presented with features of urogenital infection and lumbar pain. Performed diagnostics revealed at first epididymitis, then serum elevation of AFP, and finally renal tumor. Based on wide immunophenotyping, the tumor was histopathologically recognized as high grade clear cell renal cell carcinoma with AFP expression. Clinically the patient presented unexpected rapid cancer progression with parallel increase of above biomarker level, causing repeated exclusion assessment of germ cell tumor.
Conclusions:
The diagnostics of kidney mass in our patient was interfered and complicated by concomitant genital infection and AFP serum elevation. Clinically found increased level of AFP requires extensive evaluation, including diagnostics of different tumors.
Alpha-fetoprotein (AFP) is a glycoprotein which can be elevated in some nononcological conditions, and in few types of cancers being a diagnostic and monitoring biomarker. Kidney cancer can produce several substances, which have biological activity and even cause paraneoplastic syndromes. AFP elevation in course of renal cancer is extremely rarely encountered.
Aim:
To present diagnostic difficulties in a case of a 43-year-old man with a kidney tumor.
Case study:
Clinical and pathological case description.
Results and discussion:
The patient initially presented with features of urogenital infection and lumbar pain. Performed diagnostics revealed at first epididymitis, then serum elevation of AFP, and finally renal tumor. Based on wide immunophenotyping, the tumor was histopathologically recognized as high grade clear cell renal cell carcinoma with AFP expression. Clinically the patient presented unexpected rapid cancer progression with parallel increase of above biomarker level, causing repeated exclusion assessment of germ cell tumor.
Conclusions:
The diagnostics of kidney mass in our patient was interfered and complicated by concomitant genital infection and AFP serum elevation. Clinically found increased level of AFP requires extensive evaluation, including diagnostics of different tumors.
CONFLICT OF INTEREST
None declared.
REFERENCES (15)
1.
Escudier B, Porta C, Schmidinger M, et al. Renal cell carcinoma: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2014;25(suppl 3):iii49–iii56. http://dx.doi.org/10.1093/anno....
2.
Özlük Y, Kılıçaslan I. Syndromes that link the endocrine system and genitourinary tract. Tu€rk Patoloji Derg. 2015;31(suppl 1):155–171. http://dx.doi.org/10.5146/tjpa....
3.
Marston L, Rini B, Yang J. Cancer of the kidney. In: De Vita VT, Lawrence TS, Rosenberg SA, eds. Cancer Principles and Practice of Oncology. Philadelphia: Wolters Kluwer Health; 2011:1166.
4.
Mizejewski GJ. Alpha-fetoprotein structure and function: relevance to isoforms, epitopes, and conformational variants. Exp Biol Med (Maywood). 2001;226(5):377–408.
5.
Hong SM, Yu E, Ahn H, Kim OJ. Alpha-fetoprotein producing renal cell carcinoma: a case report. J Korean Med Sci. 1998;13(3):321–324. http://dx.doi.org/10.3346/jkms....
6.
Lin CM, Meng E, Lee SS, et al. Alpha-fetoprotein-producing renal cell carcinoma. J Med Sci. 2004;24(3):141–144.
7.
Tahtouh R, Azzi A-S, Alaaeddine N, et al. Telomerase inhibition decreases alpha-fetoprotein expression and secretion by hepatocellular carcinoma cell lines: in vitro and in vivo study. PLOS ONE. 2015;10(3):e0119512. http://dx.doi.org/10.1371/jour....
8.
Samaratunga H, Samaratunga D, Dunglison N, Perry-Keene J, Nicklin J, Delahunt B. Alpha-fetoprotein-producing carcinoma of the renal pelvis exhibiting hepatoid and urothelial differentiation. Anticancer Res. 2012;32(11):4987–4992.
9.
Morimoto H, Tanigawa N, Inoue H, Muraoka R, Hosokawa Y, Hattori T. Alpha-fetoprotein-producing renal cell carcinoma. Cancer. 1988;61(1):84–88.
10.
Delahunt B, Srigley JR. The evolving classification of renal cell neoplasia. Semin Diagn Pathol. 2015;32(2):90–102. http://dx.doi.org/10.1053/j.se....
11.
Ip S, Schaeffer DF, Yoshida EM, Kwan WP. Alpha fetoproteinsecreting gastric cancer in the setting of chronic hepatitis B: the role of endoscopy. ACG Case Rep J. 2015;2(3):152–154. http://dx.doi.org/10.14309/crj....
12.
Drozynska E, Bien E, Polczynska K, et al. A need for cautious interpretation of elevated serum germ cell tumor markers in children. Review and own experiences. Biomark Med. 2015;9(9):923–932. http://dx.doi.org/10.2217/bmm.....
14.
Zhu M, Lin B, Zhou P, Li M. Molecular analysis of AFP and HSA interactions with PTEN protein. Biomed Res Int. 2015;2015:256916. http://dx.doi.org/10.1155/2015....
15.
Żołnierek J, Wysocki P, Nurzański P. Everolimus – oral mTOR inhibitor used in treatment of tyrosine kinase inhibitorsresistant advanced kidney cancer. In: Szczylik C, Wcisło G, eds. Kidney cancer. Current treatment and diagnostics. Poznań: Termedia; 2010:226 [in Polish].
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
