Multiple Myeloma Coverage from Every Angle
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Combined Presence of Myeloma and Kidney Cancer: Two Clinical Cases

By: Dana A. Elya, MS, RD, CDN
Posted: Wednesday, May 13, 2020

A case study published in Joint Bone Spine reported on two clinical cases involving the combined presence of multiple myeloma and clear cell renal cell carcinoma. The cancers were discovered at the same time, with concomitant bone recurrence some time after the initial diagnosis. The clinical cases were reported by Béatrice Bouvard, PhD, of the Center Hospitalier Universitaire, Angers, France, and colleagues.

“Clinicians must be aware of the possibility of this disease combination and, in the event of an obvious recurrence of one of these two diseases, should search systematically for recurrence of the other disease,” the researchers concluded.

The first patient was a 66-year-old man who experienced back pain and weight loss. The patient’s history showed high blood pressure, type 2 diabetes, and a hemorrhagic stroke. A diagnosis of clear cell renal cell carcinoma was made after a kidney biopsy. No bone biopsy was performed, as the bone involvement was attributed to multiple myeloma. Kidney cancer surgery was performed, and the treatment of multiple myeloma began. Two years later, the patient was hospitalized for metastasis of clear cell renal cell carcinoma, and diffuse myelomatous proliferation was found. A surgical specimen indicated a bone metastasis of the kidney cancer.

The second patient was a 75-year-old woman who was hospitalized for worsening chronic lower back pain. The patient’s history revealed morbid obesity, long-term opioid-treated low back pain, and IgG kappa monoclonal gammopathy. A diagnosis of asymptomatic multiple myeloma was made, and a kidney tumor suspected of being malignant was found. Two years later, the patient was hospitalized and a lesion was found. A bone scan and positron-emission tomography scan confirmed a femoral lesion. A biopsy helped to diagnose a recurrence of the clear cell renal cell carcinoma with bone metastases.

Disclosure: The authors reported no conflicts of interest.



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