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Renal cell carcinoma and malignant peritoneal mesothelioma after occupational asbestos exposure: case report
Stefano Massimo Candura1, Riccardo Boeri, Cristina Teragni
1Unit of Occupational Medicine, Department of Public Health, Experimental and Forensic Sciences, University of Pavia, Italy Unit of Occupational Medicine, Salvatore Maugeri Foundation, Work and Rehabilitation, IRCCS, Scientific Institute of Pavia, Italy. stefano.candura@fsm.it.
Unlabelled:
Asbestos is the main causal factor for malignant mesothelioma (MM), a relatively rare and aggressive malignancy. Some epidemiological evidence suggests a role of this agent also in the etiology of renal cell carcinoma (RCC), the most common form of kidney cancer.
Case Report:
After 7 years of asbestos exposure, a 76-year-old asbestos-cement worker came to our notice with left flank pain. Diagnostic imaging disclosed a neoplasm in the upper two thirds of the left kidney, without evidence of metastases. After surgery (nephrectomy with para-aortic lymphadenectomy), histopathology revealed clear cell RCC. One year later, the patient was hospitalized for abdominal pain. Laparoscopy showed diffuse neoplastic infiltration of the peritoneum and liver. Histological and immunohistochemical examination of the bioptic samples led to the diagnosis of biphasic MM. The subject died 2 months later. Autopsy disclosed ascites and diffuse infiltration of the abdominal wall and viscera, without evidence of RCC relapse.
Conclusions:
This is the second reported case of association between RCC and peritoneal MM in the scientific literature. Asbestos might be involved in the causation of both malignancies.
Insights
Asbestos exposure may cause both malignant mesothelioma (MM) and renal cell carcinoma (RCC). This case report details a patient with both cancers, highlighting asbestos as a potential common etiological factor.
Area of Science:
- Oncology
- Environmental Medicine
Background:
- Asbestos is a known cause of malignant mesothelioma (MM).
- Epidemiological studies suggest asbestos may also contribute to renal cell carcinoma (RCC) development.
Observation:
- A 76-year-old asbestos-cement worker presented with flank pain and was diagnosed with clear cell RCC.
- One year post-nephrectomy, the patient developed diffuse peritoneal and liver infiltration, diagnosed as biphasic MM.
- The patient succumbed to MM two months later, with autopsy confirming widespread metastasis but no RCC recurrence.
Findings:
- This report documents the second case of co-occurring peritoneal MM and RCC in the literature.
- The clinical course suggests a potential link between asbestos exposure and the development of both malignancies.
Implications:
- Asbestos exposure is a significant risk factor for both MM and potentially RCC.
- Further research is warranted to elucidate the etiological mechanisms linking asbestos to these distinct cancers.
- Clinicians should consider occupational asbestos exposure in patients presenting with either MM or RCC, especially when co-occurring.
