A rare case of renal cancer with PLA2R-positive membranous nephropathy and AL amyloidosis: Insights into mechanisms and treatment.
Jian Zhang, Junyue Huang, Bin Zhou et al.
✦ AI-curated · Sources linked
Case in brief
An elderly male presented with nephrotic syndrome and a right renal mass, leading to a nephrectomy. Pathological examination confirmed renal clear cell carcinoma, alongside PLA2R-positive membranous nephropathy and AL amyloidosis. Despite tumor resection, nephrotic syndrome did not improve until the patient received sequential treatment with bortezomib, dexamethasone, daratumumab, and rituximab, resulting in remission.
What made this case unusual
The case is notable for the concurrent presence of PLA2R-positive membranous nephropathy and light-chain amyloidosis in the context of renal clear cell carcinoma, complicating the clinical picture.
Diagnostic / clinical pearl
Clinicians should consider secondary causes of nephrotic syndrome, such as PLA2R-positive membranous nephropathy and AL amyloidosis, in patients with renal malignancies.
Why it matters
This case highlights the need for a multidisciplinary approach in managing complex renal conditions associated with malignancies, emphasizing the interplay between different pathologies.