BERKELEY, CA (UroToday.com) - This article out of Johns Hopkins reviewed the risk of renal cell carcinoma occurring as a secondary malignancy after chemotherapy in childhood.

At the time of diagnosis, the children were between the ages of 6-22 years. Histologically, the tumor showed typical features that are described for translocation renal cell carcinomas. At the molecular level, three of the tumors contained the ASPL-TFE3 fusion; two contained Alpha-TFEB and one contained PRCC-TFE3. The time span between chemotherapy and the diagnosis of these renal cell carcinomas ranged from 4-13 years. The indications varied and including acute promyelocytic leukemia, acute myeloid leukemia, bilateral Wilms' tumor, systemic lupus erythematosus, and a conditioning regimen of bone marrow transplantation secondary to Hurler's syndrome. This latter patient also received radiation.

The group had 39 genetically confirmed translocation renal cell carcinomas in their experience with six (15%) of these arising in patients who received cytotoxic chemotherapy. They make the conclusion that cytotoxic chemotherapy may predispose patients to the development of renal translocation carcinomas.

Argani P, Lae M, Ballard ET, Amin M, Manivel C, Hutchinson B, Reuter VE, Ladanyi M.

Urological Oncology: Seminars and Original Investigation 24 (6): 558-559, December 2006.

UroToday.com Renal Cancer Section

UroToday.com Pediatric Urology Section

Written by Pasquale Casale, MD, a Contributing Editor with UroToday.

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