Онкопедиатрия. 2018; 5: 278-283
Почечно-клеточный рак у пациентки в возрасте 6 лет: редкое клиническое наблюдение
https://doi.org/10.15690/onco.v5i4.1971Аннотация
Обоснование. Согласно данным мировой литературы и данным собственных клинических наблюдений, почечно-клеточный рак (ПКР) у детей является редкой патологией. Встречаются преимущественно локализованные и местнораспространенные формы заболевания, которые характеризуются благоприятным прогнозом и редким рецидивированием. Лечебная тактика у этой группы пациентов основана на проведении радикального хирургического лечения. При наличии отдаленных метастазов проводится адъювантная химиотерапия. Препаратом выбора при метастатических формах ПКР у детей являются ингибиторы тирозинкиназы.
Описание клинического случая. Представлены краткий обзор мировой литературы по проблеме ПКР у детей, а также собственное клиническое наблюдение ПКР у пациентки в возрасте 6 лет, которая получала лечение в НИИ ДОиГ ФГБУ «НМИЦ онкологии имени Н.Н. Блохина» Минздрава России и в настоящее время здорова и находится под динамическим наблюдением.
Заключение. Редкость ПКР у детей диктует необходимость тщательного обследования и наблюдения пациентов, морфологического и молекулярно-генетического исследования опухоли с целью изучения особенностей течения и биологии «взрослых» раков у детей.
Список литературы
1. Breslow N, Olshan A, Beckwith JB, Green DM. Epidemiologyof Wilms tumor. Med Pediatr Oncol. 1993;21(3):172–181.
2. Brok J, Treger TD, Gooskens SL, et al. Biology and treatment of renal tumours in childhood. Eur J Cancer. 2016;68:179–195. doi: 10.1016/j.ejca.2016.09.005.
3. Mitry E, Ciccolallo L, Coleman MP, et al; EUROCARE Working Group. Incidence of and survival from Wilms’ tumour in adults in Europe: data from the EUROCARE study. Eur J Cancer. 2006;42(14):2363–2368. doi: 10.1016/j.ejca.2006.04.009.
4. Indolfi P, Terenziani M, Casale F, et al. Renal cell carcinoma in children: a clinicopathologic study. J ClinOncol. 2003;21(3):530–535. doi: 10.1200/JCO.2003.02.072.
5. Uchiyama M, Iwafuchi M, Yagi M, et al. Treatment of childhood renal cell carcinoma with lymph node metastasis: two cases and a review of literature. J SurgOncol. 2000;75(4):266–269. doi: 10.1002/1096-9098(200012)75:4<266::aidjso8>3.0.co;2-h.
6. Geller JI, Dome JS. Local lymph node involvement does not predict poor outcome in pediatric renal cell carcinoma. Cancer. 2004;101(7):1575–1583. doi: 10.1002/cncr.20548.
7. Freedman AL, Vates TS, Stewart T, et al. Renal cell carcinoma in children: the Detroit experience. J Urol. 1996;155:1708–1710. doi: 10.1097/00005392-199605000-00057.
8. Indolfi P, Spreafico F, Collini P, et al. Metastatic renal cell carcinoma in children and adolescents: a 30-year unsuccessful story. J Pediatr Hematol Oncol. 2012;34(7):e277–281. doi: 10.1097/MPH.0b013e318267fb12.
9. Asanuma H, Nakai H, Takeda M, et al. Renal cell carcinoma in children: experience at a single institution in Japan. J Urol. 1999;162(4):1402–1405. doi: 10.1016/s0022-5347(05)68321-8.
10. Sausville JE, Hernandez DJ, Argani P, Gearhart JP. Pediatric renal cell carcinoma. J Pediatr Urol. 2009;5(4):308–314. doi: 10.1016/j.jpurol.2009.04.007.
11. Eckschlager T, Kodet R. Renal cell carcinoma in children: a single institution experience. Med Pediatr Oncol. 1994;23(1):36–39. doi: 10.1002/mpo.2950230107.
12. Lack EE, Cassady JR, Sallan SE. Renal cell carcinoma in childhood and adolescence: a clinical and pathological study of 17 cases. J Urol. 1985;133(5):822– 828. doi: 10.1016/s0022-5347(17)49242-1.
13. Leuschner I, Harms D, Schmidt D. Renal cell carcinoma in children: histology, immunohistochemistry, and follow-up of 10 cases. Med Pediatr Oncol. 1991;19(1):33–41. doi: 10.1002/mpo.2950190107.
14. Argani P, Antonescu CR, Illei PB, et al. Primary renal neoplasms with the ASPL-TFE3 gene fusion of alveolar soft part sarcoma: a distinctive tumor entity previously included among renal cell carcinomas of children and adolescents. Am J Pathol. 2001;159(1):179–192. doi: 10.1016/S0002-9440(10)61684-7.
15. Atzpodien J, DGCIN — German Cooperative Renal Carcinoma Chemo-Immunotherapy Trials Group; Schmitt E, Gertenbach U, et al. Adjuvant treatment with interleukin-2 and interferon-alpha2a-based chemoimmunotherapy in renal cell carcinoma post tumour nephrectomy: results of a prospectively randomised trial of the German Cooperative Renal Carcinoma Chemoimmunotherapy Croup (DGCIN). Br J Cancer. 2005;92(5):843–846. doi: 10.1038/sj.bjc.6602443.
16. Bukowski RM. Cytokine combinations: therapeutic use in patients with advanced renal cell arcinoma. Semin Oncol. 2000;27(2):204–212.
17. Estrada CR, Suthar AM, Eaton SH, et al. Renal cell carcinoma: Children’s Hospital Boston experience. Urology. 2005;66(6):1296–300. doi: 10.1016/j.urology.2005.06.104.
18. Selle B, Furtwängler R, Graf N, et al. Populationbased study of renal cell carcinoma in children in Germany, 1980–2005: more frequently localized tumors and underlying disorders compared with adult counterparts. Cancer. 2006;107(12):2906–2914. doi: 10.1002/cncr.22346.
19. Otgün I, Arda IS, Haberal N, et al. Renal cell carcinoma: case report and literature review. J Pediatr Surg. 2005;40(5):e13–16. doi: 10.1016/j.jpedsurg.2005.02.013.
20. Ficarra V, Righetti R, Pilloni S, et al. Prognostic factors in patients with renal cell carcinoma: retrospective analysis of 675 cases. Eur Urol. 2002;41(2):190– 198. doi: 10.1016/s0302-2838(01)00027-6.
21. Indolfi P, Bisogno G, Cecchetto G, et al. Local lymph node involvement in pediatric renal cell carcinoma: a report from the Italian TREP project. Pediatr Blood Cancer. 2008;51(4):475–478. doi: 10.1002/pbc.21652.
22. Carcao MD, Taylor GP, Greenberg ML, et al. Renalcell carcinoma in children: a different disorder from its adult counterpart? Med Pediatr Oncol. 1998;31(3):153–158. doi: 10.1002/(sici)1096-911x(199809)31:3<153::aid-mpo5>3.3.co;2-e.
Oncopediatrics. 2018; 5: 278-283
Renal Cell Cancer in a 6 Years Old Patient: Rare Clinical Case
https://doi.org/10.15690/onco.v5i4.1971Abstract
Background. According to the data of the world literature and own data of observations renal cell carcinoma (RCC) in children is a rare pathology. There are mainly localized and locally common forms of the disease, characterized by a good prognosis and rare reccurence. The tactic of the treatment in this group of patients based on radical surgery. If there are distant metastases, adjuvant chemotherapy is performed. The drug of choice in metastatic forms is a tyrosine kinase ingibitor.
Description of a Clinical Case. A review of the world literature on the problem of RCC in children and also the clinical observation of RCC in a 6 years old patient, who treated in N.N. Blokhin National Medical Research Center of Oncology (Moscow), are presented. Now the patient is healthy and is under the dynamic observation.
Conclusion. The rarity of RCС requires careful examination and observation of patients, morphological and molecular-genetic study of the tumor for features of biology and develop of «adult» cancer in children.References
1. Breslow N, Olshan A, Beckwith JB, Green DM. Epidemiologyof Wilms tumor. Med Pediatr Oncol. 1993;21(3):172–181.
2. Brok J, Treger TD, Gooskens SL, et al. Biology and treatment of renal tumours in childhood. Eur J Cancer. 2016;68:179–195. doi: 10.1016/j.ejca.2016.09.005.
3. Mitry E, Ciccolallo L, Coleman MP, et al; EUROCARE Working Group. Incidence of and survival from Wilms’ tumour in adults in Europe: data from the EUROCARE study. Eur J Cancer. 2006;42(14):2363–2368. doi: 10.1016/j.ejca.2006.04.009.
4. Indolfi P, Terenziani M, Casale F, et al. Renal cell carcinoma in children: a clinicopathologic study. J ClinOncol. 2003;21(3):530–535. doi: 10.1200/JCO.2003.02.072.
5. Uchiyama M, Iwafuchi M, Yagi M, et al. Treatment of childhood renal cell carcinoma with lymph node metastasis: two cases and a review of literature. J SurgOncol. 2000;75(4):266–269. doi: 10.1002/1096-9098(200012)75:4<266::aidjso8>3.0.co;2-h.
6. Geller JI, Dome JS. Local lymph node involvement does not predict poor outcome in pediatric renal cell carcinoma. Cancer. 2004;101(7):1575–1583. doi: 10.1002/cncr.20548.
7. Freedman AL, Vates TS, Stewart T, et al. Renal cell carcinoma in children: the Detroit experience. J Urol. 1996;155:1708–1710. doi: 10.1097/00005392-199605000-00057.
8. Indolfi P, Spreafico F, Collini P, et al. Metastatic renal cell carcinoma in children and adolescents: a 30-year unsuccessful story. J Pediatr Hematol Oncol. 2012;34(7):e277–281. doi: 10.1097/MPH.0b013e318267fb12.
9. Asanuma H, Nakai H, Takeda M, et al. Renal cell carcinoma in children: experience at a single institution in Japan. J Urol. 1999;162(4):1402–1405. doi: 10.1016/s0022-5347(05)68321-8.
10. Sausville JE, Hernandez DJ, Argani P, Gearhart JP. Pediatric renal cell carcinoma. J Pediatr Urol. 2009;5(4):308–314. doi: 10.1016/j.jpurol.2009.04.007.
11. Eckschlager T, Kodet R. Renal cell carcinoma in children: a single institution experience. Med Pediatr Oncol. 1994;23(1):36–39. doi: 10.1002/mpo.2950230107.
12. Lack EE, Cassady JR, Sallan SE. Renal cell carcinoma in childhood and adolescence: a clinical and pathological study of 17 cases. J Urol. 1985;133(5):822– 828. doi: 10.1016/s0022-5347(17)49242-1.
13. Leuschner I, Harms D, Schmidt D. Renal cell carcinoma in children: histology, immunohistochemistry, and follow-up of 10 cases. Med Pediatr Oncol. 1991;19(1):33–41. doi: 10.1002/mpo.2950190107.
14. Argani P, Antonescu CR, Illei PB, et al. Primary renal neoplasms with the ASPL-TFE3 gene fusion of alveolar soft part sarcoma: a distinctive tumor entity previously included among renal cell carcinomas of children and adolescents. Am J Pathol. 2001;159(1):179–192. doi: 10.1016/S0002-9440(10)61684-7.
15. Atzpodien J, DGCIN — German Cooperative Renal Carcinoma Chemo-Immunotherapy Trials Group; Schmitt E, Gertenbach U, et al. Adjuvant treatment with interleukin-2 and interferon-alpha2a-based chemoimmunotherapy in renal cell carcinoma post tumour nephrectomy: results of a prospectively randomised trial of the German Cooperative Renal Carcinoma Chemoimmunotherapy Croup (DGCIN). Br J Cancer. 2005;92(5):843–846. doi: 10.1038/sj.bjc.6602443.
16. Bukowski RM. Cytokine combinations: therapeutic use in patients with advanced renal cell arcinoma. Semin Oncol. 2000;27(2):204–212.
17. Estrada CR, Suthar AM, Eaton SH, et al. Renal cell carcinoma: Children’s Hospital Boston experience. Urology. 2005;66(6):1296–300. doi: 10.1016/j.urology.2005.06.104.
18. Selle B, Furtwängler R, Graf N, et al. Populationbased study of renal cell carcinoma in children in Germany, 1980–2005: more frequently localized tumors and underlying disorders compared with adult counterparts. Cancer. 2006;107(12):2906–2914. doi: 10.1002/cncr.22346.
19. Otgün I, Arda IS, Haberal N, et al. Renal cell carcinoma: case report and literature review. J Pediatr Surg. 2005;40(5):e13–16. doi: 10.1016/j.jpedsurg.2005.02.013.
20. Ficarra V, Righetti R, Pilloni S, et al. Prognostic factors in patients with renal cell carcinoma: retrospective analysis of 675 cases. Eur Urol. 2002;41(2):190– 198. doi: 10.1016/s0302-2838(01)00027-6.
21. Indolfi P, Bisogno G, Cecchetto G, et al. Local lymph node involvement in pediatric renal cell carcinoma: a report from the Italian TREP project. Pediatr Blood Cancer. 2008;51(4):475–478. doi: 10.1002/pbc.21652.
22. Carcao MD, Taylor GP, Greenberg ML, et al. Renalcell carcinoma in children: a different disorder from its adult counterpart? Med Pediatr Oncol. 1998;31(3):153–158. doi: 10.1002/(sici)1096-911x(199809)31:3<153::aid-mpo5>3.3.co;2-e.
