Clear-cell renal cell carcinoma and glioblastoma multiforme coexistence: Double primary malignancy, does it have a causal relationship?

Abstract

Background: Multiple primary malignancies (MPMs), especially coexistence of renal cell carcinoma (RCC) and glioblastoma multiforme (GBM), are rare. The most likely clinical diagnosis in patient with tumor in another organ is metastatic brain tumor. Although GBM is the most common brain tumor, it is rarely coexistent with other malignancies. Case Description: A 64-year-old female presented with headache and dizziness, along with abdominal pain for 2 weeks before being admitted. The abdominal computed tomography (CT) scan showed a kidney tumor. The patient developed left hemiplegia, and the brain CT scan showed an intracranial tumor. The patient suggested for radical nephrectomy and craniotomy tumor removal. Histopathology of the kidney and brain tumor revealed two different features, which showed RCC and GBM. Immunohistochemistry result confirmed the diagnosis of GBM and IDH1 wild type; coexistent with clear cell RCC. Conclusion: The coexistence of carcinoma and glioma should be regarded as coincidental cases if it did not accomplish the criteria for tumor-to-tumor metastasis or proven to be a genetic syndrome. This case report provides an addition to the literature about double primary malignancy in a single patient. More studies are needed to confirm whether they have causal relationship or merely coincidental findings.

Letter to the Editor regarding “Clear-cell renal cell carcinoma and glioblastoma multiforme coexistence: Double primary malignancy, does it have a causal relationship?”

“…Simanjuntak et al have admirably described both their case and Franke et al's cases; we refer readers to review Simanjuntak et al for a complete description of these cases. [2,10] We have subsequently identified two case reports not described by Simanjuntak et al, a recently reported case series/database analysis including 126 cases of RCC followed by GBM, and an investigation of malignancies in long-term survivors (LTS) of GBM that describes one RCC arising in a patient with an existing GBM diagnosis. [4,8,9,11] A brief overview of all cases is found in Table 1.…”

“…Death from GBM Long-term survivor of GBM who later developed RCC Simanjuntak et al [10] 2022 64, F Concurrent Right temporal lobe…”

“…[2] Different patterns of coincidental RCC and GBM have been reported, including both synchronous and metachronous presentations. [2,4,[8][9][10][11] Although no clear relationship between these two cancers has been elucidated, it has been suggested that they may cooccur due to therapeutic side effects, underlying genetic syndromes, or as an unfortunate coincidence.…”

“…It has been suggested RCC and GBM may occur in the same patient as part of genetic syndromes, although there is no clear evidence as to which genes, alleles, or mutations are responsible. [10,11] Simanjuntak et al implicate genetic syndromes, such as Li-Fraumeni syndrome, neurofibromatosis, and VHL, as possibly being involved. [10] Notably, VHL is an established predisposition to developing RCC, although it does not seem to play a role in GBM.…”

“…[10,11] Simanjuntak et al implicate genetic syndromes, such as Li-Fraumeni syndrome, neurofibromatosis, and VHL, as possibly being involved. [10] Notably, VHL is an established predisposition to developing RCC, although it does not seem to play a role in GBM. Krieg et al show that VHLassociated hemangioblastomas display distinct genetic features from GBM, and GBM displays wild-type VHL expression.…”