Concurrent renal cell carcinoma and hematologic malignancies: Nine case reports

Table 1 Patients with concurrent renal cell carcinoma and hematologic malignancies at our institution

Case	Age at RCC	Grade/Stage/Histology RCC	RCC treatment	Hematologic malignancy	Duration between RCC and HM diagnoses	Treatment for HM
1	68	Grade 2 PRCC with oncocytic features; clinical Stage 1	None	Grade 2 Stage 4 follicular lymphoma	RCC 10 wk before LM	(1) Bendamustine/rituximab; (2) Follow up 49 mo after kidney biopsy; and (3) Still alive with both malignancies in remission
2	70	Stage 3 Grade 4 CCRCC	Radical nephrectomy	Stage 4 mantle cell lymphoma	Simultaneous	(1) Bendamustine/rituximab; imbruvica; bortezomib; rituximab/lenalidomide; and (2) Acute kidney injury, died 54 mo after nephrectomy as result of mantle cell lymphoma; CCRCC in remission
3	55	Stage 1 Grade 2 CCRCC	Radical nephrectomy	Multiple myeloma	RCC 7 wk before LM	(1) Bortezomib/cyclophosphamide/dexamethasone; (2) Autotransplant; (3) Lanelidomide; pazopanib; cabozantinib; nivolumab/ipilimumab; axitinib; lenvatinib/everolimus; atezolizumab/bevacizumab; and (4) Died 70 mo after nephrectomy due to metastatic CCRCC
4	62	Stage 1 Grade 3 CCRCC	Radical nephrectomy	Stage 3 Grade 3 follicular lymphoma	Simultaneous	(1) Cyclophosphamide/doxorubicin hydrochloride/ palonosetron/rituximab/vincristine (CHOP); rituximab; pazopanib, cabozantinib; and (2) Died 64 mo after nephrectomy and lymph node dissection of progressive metastatic CCRCC
5	58	Stage 1 Unclassified RCC	Partial nephrectomy	Stage 4 non-sclerosing Hodgkin’s lymphoma	RCC 109 mo before LM	(1) Brentuximab vedotin/doxorubicin/vinblastine/dacarbazine (AAVD); and (2) Follow up 23 mo after lymph node biopsy; (3) Still alive with no evidence of recurrent lymphoma or RCC
6	55	Stage 1 CCRCC	Partial nephrectomy	Stage 1E diffuse large B-cell lymphoma	CCRCC 75 mo before LM	(1) No cytotoxic chemotherapy; (2) Splenectomy; (3) Follow up 112 mo after nephrectomy and 37 mo after splenectomy; and (4) Still alive with no evidence of recurrent lymphoma or CCRCC
7	59	Clinical Stage 1 RCC	None	Low-grade follicular center cell lymphoma of skin	LM 9 wk before RCC	(1) No cytotoxic chemotherapy; (2) Excision of skin lymphoma; (3) Follow up 17 mo after kidney biopsy confirming lymphoma; and (4) Kidney CA on surveillance and no recurrent lymphoma
8	71	Stage 4 Grade 2 leiomyosarcoma of the kidney	Kidney biopsy; radical nephrectomy 9 mo later	B cell lymphoma Stage 1E of the kidney	Simultaneous	(1) Gemcitabine/docetaxel anhydrous; ipilimumab/nivolumab; (2) Follow up 11 mo after biopsy confirming leiomyosarcoma of the kidney; and (3) Still alive with continued response of metastatic kidney cancer on check point inhibitor; no treatment for lymphoma
9	77	Clinical Stage 1 RCC	None	Diffuse large B-cell lymphoma subtype activated B-cell, Stage 2E	Simultaneous	(1) Rituximab/cyclophosphamide/etoposide/vincristine/prednisone; (2) Follow up 12 mo after kidney biopsy confirming lymphoma; and (3) Still alive with no evidence of recurrent RCC or lymphoma

RCC: Renal cell carcinoma; HM: Hematologic malignancy; PRCC: Papillary renal cell carcinoma; CCRCC: Clear cell renal cell carcinoma.

Table 2 Concurrent renal cell carcinoma and hematologic malignancies in the literature

Study	Gender (M/F)	Number of patients with HM diagnosed first	Number of patients with simultaneous diagnosis of RCC and HM	Number of patients with RCC diagnosed first	Most common HM
Anderson et al[3], 1988, (n = 41)	32 (78)/9 (22)	17 (41)	8 (20)	16 (39)	NHL: 41 (100)
Nishikubo et al[1], 1996, (n = 8)	7 (88)/1 (12)	4 (50)	0 (0)	4 (50)	NHL: 2 (25); CLL: 2 (25); MM: 2 (25)
Tihan et al[5], 1996, (n = 15)	4 (27)/ 11 (73)	0 (0)	14 (93)	1 (7)	NHL: 15 (100)
Ohsawa et al[11], 1998, (n = 42)	27 (64)/15 (36)	38 (90)	4 (10)	0 (0)	NHL: 42 (100)
Kunthur et al[10], 2006, (n = 9)	8 (89)/1 (11)	6 (67)	1 (11)	2 (22)	NHL: 6 (67)
Choueiri et al[4], 2008, (n = 8)	6 (75)/2 (25)	4 (50)	0 (0)	4 (50)	MM: 8 (100)
Serefhanoglu et al[2], 2010, (n = 5)	5 (100)/ 0 (0)	2 (40)	3 (60)	0 (0)	CLL: 3 (60)
Dutcher et al[8], 2016, (n = 26)	18 (69)/8 (31)	16 (62)	2 (5)	8 (31)	NHL: 13 (50)
Current study, 2020, (n = 9)	9 (100)/0 (0)	1 (11)	4 (44)	4 (44)	NHL: 7 (78)

HM: Hematologic malignancy; MM: Multiple myeloma; CLL: Chronic lymphocytic leukemia; NHL: Non-Hodgkin’s lymphoma; RCC: Renal cell carcinoma.