Jolanta Soltysiak1, Danuta Ostalska-Nowicka2, Katarzyna Zaorska3, Karolina Sterzyńska3, Katarzyna Derwich4, Jacek Zachwieja2. 1. Department of Pediatric Cardiology, Nephrology and Hypertension, Poznan University of Medical Sciences, 27/33 Szpitalna Str, 60-572, Poznan, Poland. jsoltysiak1@gmail.com. 2. Department of Pediatric Cardiology, Nephrology and Hypertension, Poznan University of Medical Sciences, 27/33 Szpitalna Str, 60-572, Poznan, Poland. 3. Department of Histology and Embryology, Poznan University of Medical Sciences, Poznan, Poland. 4. Department of Pediatric Hematology and Oncology, Poznan University of Medical Sciences, Poznan, Poland.
Abstract
BACKGROUND: Nephrotic-range proteinuria as a paraneoplastic syndrome (PNS) is an exceptional presentation, especially in children. It is usually associated with hematologic malignancies. Solid tumors are very rare causes of proteinuria. CASE-DIAGNOSIS/TREATMENT: We present the case of a 7-year-old boy with an extremely rare atypical thymic carcinoid accompanied by nephrotic-range proteinuria as PNS. The kidney biopsy was consistent with minimal change disease (MCD). Tests for a neuroendocrine tumor were performed due to symptoms of hypercortisolemia and an elevated concentration of chromogranin A in the serum. The chest computed tomography revealed a tumor in the anterior mediastinum, which was diagnosed as an atypical thymic carcinoid. A complete resolution of the nephrotic-range proteinuria was observed within 1 week after the first thoracoscopic surgery, with almost complete reduction of the tumor mass. CONCLUSIONS: This extremely rare case shows that MCD can occur as a PNS even in children. Nephrotic-range proteinuria can be a symptom of malignant solid tumor. This case highlights the possibility of secondary causes of MCD in children.
BACKGROUND: Nephrotic-range proteinuria as a paraneoplastic syndrome (PNS) is an exceptional presentation, especially in children. It is usually associated with hematologic malignancies. Solid tumors are very rare causes of proteinuria. CASE-DIAGNOSIS/TREATMENT: We present the case of a 7-year-old boy with an extremely rare atypical thymic carcinoid accompanied by nephrotic-range proteinuria as PNS. The kidney biopsy was consistent with minimal change disease (MCD). Tests for a neuroendocrine tumor were performed due to symptoms of hypercortisolemia and an elevated concentration of chromogranin A in the serum. The chest computed tomography revealed a tumor in the anterior mediastinum, which was diagnosed as an atypical thymic carcinoid. A complete resolution of the nephrotic-range proteinuria was observed within 1 week after the first thoracoscopic surgery, with almost complete reduction of the tumor mass. CONCLUSIONS: This extremely rare case shows that MCD can occur as a PNS even in children. Nephrotic-range proteinuria can be a symptom of malignant solid tumor. This case highlights the possibility of secondary causes of MCD in children.
Authors: Fernando Guerrero-Pérez; Inmaculada Peiró; Agustina Pia Marengo; Alex Teulé; José Carlos Ruffinelli; Roger Llatjos; Teresa Serrano; Ivan Macia; Nuria Vilarrasa; Pedro Iglesias; Carles Villabona Journal: Rev Endocr Metab Disord Date: 2021-05-07 Impact factor: 6.514