Višestruki zloćudni tumori u pacijenta s leukemijom vlasastih stanica: prikaz slučaja

Abstract

Aim: To present a patient with metachronous occurrence of liposarcoma, HCL (hairy cell leukemia) and renal cell carcinoma and analyze previous literature data about occurrence of multiple malignancies in HCL patients. Case report: We report a case of a 38-year-old patient who operated and treated liposarcoma with radiotherapy and in whom was found pathological metabolic activity of bone marrow on PET/CT (Positron emission tomography/Computed tomography). This finding raised a suspicion about the existence of lymphoproliferative disease and the patient was sent to hematological examination in which was revealed that patient has HCL. The patient was monitored and treatment with cladribine was started after there was deterioration in the blood count. Subsequently remission occured. Abdominal ultrasound was done and focal lesion of left kidney was found. Partial nefrectomy of the left kidney was done. Histopathological analysis revealed clarocellular kidney carcinoma. Conclusion: The patients with HCL have a higher risk of developing other malignant diseases, both solid tumors, and other hematologic neoplasms. It is important to think of secondary malignancies during the patient's monitoring, since secondary malignances are a frequent cause of morbidity and mortality in HCL patients. The patient with this type of limphoproliferative disease needs to be closely monitored and also needs to keep up with primary and secondary measures to prevent cancer development. Further research about the correlation of chemotherapy and incidence of secondary malignancies is needed, but also it is important to research immunological and other pathophysiological mechanisms which can increase the occurence of secondary malignancies.