Zusammenfassung
Nierenzellkarzinomassoziierte paraneoplastische Syndrome reichen von Veränderungen des Allgemeinzustands bis hin zu spezifischen metabolischen und biochemischen Veränderungen. Sie treten bei bis zu 40% der Patienten mit einem Nierenzellkarzinom im Krankheitsverlauf auf. Der vorliegende Beitrag erläutert die häufigsten beim Nierenzellkarzinom vorkommenden paraneoplastischen Veränderungen und beschreibt einige seltene Varianten sowie deren Manifestation und Therapie. Zusätzlich wird auf die vermuteten pathophysiologischen Mechanismen eingegangen. Die Bedeutung der nierenzellkarzinomassoziierten paraneoplastischen Manifestationen liegt u. a. in ihrer Rolle, ein möglicher Vorbote des Tumors oder seines Rezidivs zu sein. Dabei kennzeichnet ein solches paraneoplastisches Syndrom nicht zwingend eine schlechte Prognose oder das Vorliegen einer Metastasierung.
Abstract
Renal cell carcinoma associated paraneoplastic symptoms include constitutional symptoms as well as specific metabolic and biochemical abnormalities. These are present in up to 40% of patients with renal cell carcinoma during the course of the disease. This report provides information on the most common manifestations and their therapy; some rare variants are also mentioned. The importance of paraneoplasia lies partly in the fact that paraneoplastic symptoms may be the precursor of either primary or recurrent disease. The presence of paraneoplastic manifestations does not necessarily imply a poor prognosis or metastatic disease.
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Literatur
Weissglas M, Schamhart D, Lowik C et al. (1995) Hypercalcemia and cosecretion of interleukin-6 and parathyroid hormone related peptide by a human renal cell carcinoma implanted into nude mice. J Urol 153: 854–857
Mundy GR (1990) Pathophysiology of cancer-associated hypercalcemia. Semin Oncol 17: 10–15
Yasuda T, Banville D, Hendy GN, Goltzman D (1989) Characterization of the human parathyroid hormone-like peptide gene. Functional and evolutionary aspects. J Biol Chem 264: 7720–7725
Ritch PS (1990) Treatment of cancer-related hypercalcemia. Semin Oncol 17: 26–33
Kirchner FK Jr, Braren V, Smith C et al. (1976) Renal carcinoma discovered incidentally by arteriography during evaluation for hypertension. J Urol 115: 643–645
Palapattu GS, Kristo B, Rajfer J (2002) Paraneoplastic syndromes in urologic malignancy: the many faces of renal cell carcinoma. Rev Urol 4: 163–170
Lindop GB, Fleming S (1984) Renin in renal cell carcinoma--an immunocytochemical study using an antibody to pure human renin. J Clin Pathol 37: 27–31
Antonipillai I (1993) Epidermal growth factor is a potent inhibitor of renin secretion. Hypertension 21: 654–659
Antonipillai I, Le TH, Soceneantu L, Horton R (1993) Transforming growth factor-beta is a renin secretagogue at picomolar concentrations. Am J Physiol 265: F537–541
Dahl T, Eide I, Fryjordet A (1981) Hypernephroma and hypertension. Two case reports. Acta Med Scand 209: 121–124
Pedrinelli R, Graziadei L, Taddei S et al. (1987) A renin-secreting tumor. Nephron 46: 380–385
Maldonado JE, Sheps SG, Bernatz PE et al. (1964) Renal arteriovenous fistula. A reversible cause of hypertension and heart failure. Am J Med 37: 499–513
Papac RJ, Poo-Hwu WJ (1999) Renal cell carcinoma: a paradigm of lanthanic disease. Am J Clin Oncol 22: 223–231
Da Silva JL, Lacombe C, Bruneval P et al. (1990) Tumor cells are the site of erythropoietin synthesis in human renal cancers associated with polycythemia. Blood 75: 577–582
Kvarstein B, Lindemann R, Mathisen W (1973) Renal carcinoma with increased erythropoietin production and secondary polycythemia. Scand J Urol Nephrol 7: 178–180
Asano S, Okano A, Ozawa K et al. (1990) In vivo effects of recombinant human interleukin-6 in primates: stimulated production of platelets. Blood 75: 1602–1605
Stauffer M (1961) Nephrogeneous hepatosplenomegalie. Gastroenterology 40: 694
Strum WB (1984) Remote recurrence of renal cell carcinoma. Urology 23: 68–70
Giannakos G, Papanicolaou X, Trafalis D et al. (2005) Stauffer’s syndrome variant associated with renal cell carcinoma. Int J Urol 12: 757–759
Darnell RB (1996) Onconeural antigens and the paraneoplastic neurologic disorders: at the intersection of cancer, immunity, and the brain. Proc Natl Acad Sci USA 93: 4529–4536
Gjone E, Nordoy A (1970) Dermatitis herpetiformis, steatorrhoea, and malignancy. Br Med J 1: 610
Lacour JP, Castanet J, Perrin C et al. (1993) Cutaneous leukocytoclastic vasculitis and renal cancer: two cases. Am J Med 94: 104–108
Duncan LE, Hemming JD (1994) Renal cell carcinoma of the kidney and hypertrichosis lanuginosa acquisita. Br J Urol 74: 678–679
Vanatta PR, Silva FG, Taylor WE, Costa JC (1983) Renal cell carcinoma and systemic amyloidosis: demonstration of AA protein and review of the literature. Hum Pathol 14: 195–201
Karsenty G, Ulmann A, Droz D et al. (1985) Clinical and histological resolution of systemic amyloidosis after renal cell carcinoma removal. Nephron 40: 232–234
Tsukamoto T, Kumamoto Y, Miyao N et al. (1992) Interleukin-6 in renal cell carcinoma. J Urol 148: 1778–1772
Kim HL, Belldegrun AS, Freitas DG et al. (2003) Paraneoplastic signs and symptoms of renal cell carcinoma: implications for prognosis. J Urol 170: 1742–1746
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Bedke, J., Buse, S., Kurosch, M. et al. Paraneoplastische Syndrome des Nierenzellkarzinoms. Urologe 46, 45–48 (2007). https://doi.org/10.1007/s00120-006-1269-2
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DOI: https://doi.org/10.1007/s00120-006-1269-2