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Resolution of multiorgan sarcoid-like reaction after treatment of renal cell carcinoma
  1. Monish Patil1,
  2. Mohamed Omran Breish1,
  3. Sanjeev Madaan2 and
  4. Bikram Bhattacharjee3
  1. 1Urology, Dartford and Gravesham NHS Trust, Dartford, UK
  2. 2Urology & Nephrology, Darent Valley Hospital, Dartford, UK
  3. 3Dartford and Gravesham NHS Trust, Dartford, UK
  1. Correspondence to Professor Sanjeev Madaan; sanjeev.madaan{at}nhs.net

Abstract

Sarcoid -like reactions (SLRs) can occur in several malignancies adjacent to primary tumour location or the draining lymph nodes. The presence of peritumoural and intratumoural SLR in patients suffering from renal cell carcinoma (RCC) has been reported in few instances. However, the association of RCC with SLR in spleen, liver and other organs in the absence of systemic sarcoidosis is very rare.

We present an unusual case of a gentleman in his 30s, who presented with a lesion in the left kidney along with non-specific lesions (likely granulomatous) in liver, spleen and lungs. Partial Nnephrectomy specimen confirmed conventional/clear cell RCC. The histopathology revealed an extensive epithelioid granulomatous reaction affecting both peritumoural and intratumoural areas. Follow-up images demonstrated an almost complete resolution of lesions in the spleen, liver and lungs. Our case supports the hypothesis that non-caseating granulomas of SLR could be a manifestation of an immunologically mediated antitumour response.

  • Renal intervention
  • Cancer intervention

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Footnotes

  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content—MP and MOB. BB contributed to the manuscript by radiological reporting and actively participating in multidisciplinary team meetings. The following author gave final approval of the manuscript—SM.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.