Paraneoplastic Focal Segmental Glomerulosclerosis in a Patient with Lung Adenocarcinoma

Abstract

Focal segmental glomerulosclerosis (FSGS) is extremely rare among paraneoplastic nephrotic syndromes. We herein report a case of lung adenocarcinoma with nephrotic syndrome caused by paraneoplastic FSGS. A 68-year-old man visited our hospital for an evaluation of a right hilar mass on chest radiography and supraclavicular lymphadenopathy. Because an aspiration biopsy of the supraclavicular lymph node revealed adenocarcinoma, the patient was diagnosed with lung adenocarcinoma. He also had nephrotic syndrome, and the pathological findings of the renal biopsy demonstrated FSGS. Standard-dose carboplatin-containing chemotherapy led to a partial response for lung cancer and improved the patient's nephrotic syndrome without causing any adverse renal effects.

Paraneoplastic immunoglobulin A nephropathy in a patient with lung adenocarcinoma: A case report and literature review

“…19 The diagnosis of paraneoplastic nephropathy is based on the entire clinical process and the characteristic symptoms in the presence of malignancy. 20 The diagnosis of paraneoplastic nephropathy is based on several criteria: (i) no alternative aetiology Table 1. Clinical course of a 49-year-old male patient that presented with oedema, hypoproteinaemia and proteinuria subsequent to the diagnosis and treatment of lung adenocarcinoma during ongoing follow-up.…”

“… 19 The diagnosis of paraneoplastic nephropathy is based on the entire clinical process and the characteristic symptoms in the presence of malignancy. 20 The diagnosis of paraneoplastic nephropathy is based on several criteria: (i) no alternative aetiology other than neoplastic disease; (ii) the correlation of the diagnosis of glomerulopathy and diagnosis of neoplastic disease; (iii) the improvement of glomerulopathy after surgical removal or chemotherapy or radiotherapy of the tumour; (iv) the worsening of glomerulopathy after tumour recurrence. 19 …”

A Case of Collapsing Glomerulopathy Secondary to Romidepsin Therapy in a Patient With Subcutaneous Panniculitis-Like T-Cell Lymphoma

“…Paraneoplastic FSGS in lung adenocarcinoma has been reported [38]. Furthermore, collapsing FSGS can be associated with the hemophagocytosis syndrome, an activation of bone marrow histocytes which phagocytose blood cell precursors and can be seen with underlying infections, autoimmune diseases, and lymphomas.…”

Primary lung cancer firstly presents as nephrotic syndrome: one case report and literature review

“…Approximately 80% to 90% of nephrotic syndrome cases in adults are idiopathic ( 1 ). Nephrotic syndrome has been considered as a potential paraneoplastic process for approximately one century which may precede the onset of the primary tumor, and the eradication of initial tumor can result in the remission of nephrotic syndrome ( 2 ). There is enough literature data regarding the association between nephrotic syndrome and different neoplasia, but only few cases address the specific link between nephrotic syndrome and lung cancer, especially when nephrotic syndrome firstly presents as paraneoplastic syndrome of primary lung cancer ( 3 ).…”