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An association between renal cell carcinoma and multiple myeloma: a case series and clinical implications
Author(s) -
Choueiri Toni K.,
Baz Rachid C.,
McFadden Carolyn M.,
Khasawneh Mohamad,
Karam Mary Ann,
Kelly Megan,
Hussein Mohamad A.
Publication year - 2008
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2007.07268.x
Subject(s) - renal cell carcinoma , medicine , concomitant , exact test , multiple myeloma , incidence (geometry) , malignancy , medical record , carcinoma , gastroenterology , urology , optics , physics
OBJECTIVE To describe an association between renal cell carcinoma (RCC) and multiple myeloma (MM) in patients with both disorders, and suggest possible explanations for the association. PATIENTS AND METHODS We retrospectively reviewed the records of patients with MM and RCC at the Cleveland Clinic between 1990 and 2005, and identified 1100 with MM, 2704 with RCC and eight with concomitant MM and RCC. The medical records of these eight patients were reviewed. RESULTS In four of the eight patients, RCC was diagnosed after the MM at 3, 8, 23 and 46 months, respectively; in the remaining four, the RCC was diagnosed before MM by 108, 35, 13 and 1 months, respectively. The number of cases of RCC expected in the present 1100 patients with MM over 15 years was lower than the four recorded ( P < 0.001, Fisher’s exact test). Similarly, the number of cases of MM expected in the 2704 patients with RCC was also lower than the four recorded ( P < 0.001, Fisher’s exact test). CONCLUSIONS RCC and MM can occur in the same patient at an incidence higher than the expected rate. Possible explanations include genetic abnormalities, environmental exposures or immune‐related mechanisms predisposing to the second malignancy. These findings are particularly relevant in the management of patients with known RCC and lytic bone lesions, or those with known MM and subsequent or concomitant renal masses, especially those involving the right kidney.