E. Roussel MD, PhD

Primary renal lymphoma: A case report

SUMMARY

Renal tumours are often incidentally detected in routine imaging studies. Whereas renal cell carcinoma (RCC) represents the mainstay of malignant tumours arising from the kidney, other tumoural entities might also present as a single, localised renal mass. Primary renal lymphoma (PRL) is a distinct, rare and often aggressive presentation of lymphoma confined to the kidney, often mistaken for RCC or other renal tumours. It is defined as a non-Hodgkin lymphoma of the kidney without any extra renal lymphatic disease. Symptoms are often haematuria or flank pain. In 50% of the cases, patients are asymptomatic. The pathophysiology is not well understood. Imaging can be helpful in making the right diagnosis, but renal mass biopsy appears to be more sensitive. The treatment of choice is chemotherapy. The prognosis is rather poor, with a median survival of less than one year. Since the introduction of the new chemotherapy combination with rituximab, the prognosis is slightly better. PRL needs to be a differential diagnosis in renal tumours, especially with atypical tumour characteristics. This article presents a recent case of primary renal lymphoma.

(BELG J MED ONCOL 2024;18(2):60–64)

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Patient selection strategies throughout the renal cell carcinoma disease spectrum

SUMMARY

The present doctoral thesis manuscript aims to inform disease prognosis and guide therapeutic decision-making at all stages of the renal cell carcinoma disease spectrum. Novel imaging methods to improve pre-surgical characterisation of renal masses were developed, as well as prediction models for the estimation of postoperative renal function. Next, four molecular subtypes of clear cell renal cell carcinoma were described, their underlying disease biology and their implications in both the localised and metastatic settings. Moreover, the potential candidates for cytoreductive surgery were described, as well as the morbidity accompanying such procedures in the metastatic setting.

(BELG J MED ONCOL 2023;17(1):31–2)

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Succinate dehydrogenase B deficient renal cell carcinoma in a young adult with paraganglioma: Management of a rare, hereditary malignancy

SUMMARY

Succinate dehydrogenase deficient renal cell carcinoma (SDH-RCC) is a very rare but distinct renal neo-plasm, most often presenting at a young age and commonly associated with paragangliomas, pheochromocytomas and gastro-intestinal stromal tumours as a hereditary cancer syndrome. Although SDH-RCCs often have a relatively indolent disease course, higher nuclear grade, coagulative necrosis and sarcomatoid dedifferentiation may indicate aggressive disease. Radical surgery and (targeted) radiation therapy are valuable options in the treatment of these rare tumours. Genetic testing for germline SDH mutations is crucial. First-line relatives with germline SDH mutations should undergo periodical screening since early detection is paramount. The strong presence of the Warburg effect in SDH-related tumours make these the hallmark tumour for ¹⁸Fluorodeoxyglucose Positron Emission Tomography based screening and follow-up.

(BELG J MED ONCOL 2021;15(1):44-7)

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Primary squamous cell carcinoma of the male posterior urethra: a rare urogenital malignancy

Primary urethral cancer is an extremely rare and aggressive malignancy. Due to its rarity and the lack of large prospective trials, no standardised treatment protocols are currently available, and treatment decisions are most often made on a case-to-case basis. We present the case of a 62-year-old male with squamous cell carcinoma of the posterior urethra treated at our institution followed by an in-depth discussion on presentation, diagnosis and treatment of this rare cancer.

(BELG J MED ONCOL 2019;13(1):27–30)

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Emerging M+ RCC treatments from EAU Guidelines

Thanks to our improved understanding of the molecular pathogenesis of metastatic renal cell carcinoma, multiple new treatment agents have appeared and extended our therapeutic possibilities. Novel molecular-targeted agents have vastly replaced cytokine therapies but pointed out new challenges in finding the optimal sequence and/or combination in treating metastatic renal cell carcinoma patients. This review focusses on the emerging therapeutic options according to the European Association of Urology guidelines in the rapidly changing renal cell carcinoma landscape.

(BELG J MED ONCOL 2018;12(6):293–300)

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