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[Cyclophosphamide-induced renal pelvic tumor--a case report]
N Yoshimura1, H Kanda, R Suzuki
1Department of Urology, Mie University Faculty of Medicine.
Hinyokika Kiyo. Acta Urologica Japonica
|May 12, 2000
Summary
This case study highlights a rare instance of transitional cell carcinoma in the renal pelvis of a young man. The tumor developed after extensive cyclophosphamide treatment for rhabdomyosarcoma, suggesting a potential drug-induced link.
Area of Science:
- Oncology
- Urology
- Medical Case Reports
Background:
- Transitional cell carcinoma (TCC) is a malignant neoplasm arising from the urothelium.
- Chemotherapy, particularly with alkylating agents like cyclophosphamide (CPM), is a known risk factor for secondary malignancies.
- Upper tract urothelial carcinomas are rare, especially in younger individuals.
Observation:
- A 24-year-old male presented with a filling defect in the left renal pelvis.
- Diagnostic imaging, including computerized tomography and magnetic resonance imaging, indicated a left renal pelvic tumor.
- The patient had a history of retroperitoneal rhabdomyosarcoma treated with a cumulative dose of 42.2 g of cyclophosphamide over 27 months.
Findings:
- Histopathological examination confirmed the tumor as transitional cell carcinoma, grade 2, pT1N0M0.
- The patient underwent a left nephroureterectomy for tumor removal.
- No evidence of recurrence was observed 17 months post-surgery.
Implications:
- This case suggests a potential association between cyclophosphamide therapy and the development of upper urothelial carcinoma.
- It underscores the importance of long-term surveillance for secondary malignancies in patients treated with chemotherapy.
- This represents one of the few reported cases of cyclophosphamide-induced upper urothelial carcinoma in Japan, contributing to understanding drug-related oncogenesis.