Service de rhumatologie, CHU d'Angers, 4, rue Larrey, 49933 Angers, France.
Service de rhumatologie, CHU d'Angers, 4, rue Larrey, 49933 Angers, France; Groupe d'Etudes sur le Remodelage Osseux et les bioMatériaux, UPRES EA 4658, CHU d'Angers, 49933 Angers, France.
Joint Bone Spine. 2020 Jul;87(4):351-353. doi: 10.1016/j.jbspin.2020.03.001. Epub 2020 Mar 5.
The combined presence of two cancers in a single patient is rare. Usually, the second cancer is caused by immunosuppression resulting from treatment (chemotherapy, radiotherapy) of the first neoplasia. Multiple myeloma and kidney cancer share similar risk factors (obesity, smoking, hypertension), and several cases involving the combination of these two neoplasias have been described in the literature. We are reporting, for the first time, two clinical cases involving the combined presence of multiple myeloma and clear cell renal cell carcinoma discovered synchronously, with concomitant bone recurrence some time after the initial diagnosis. Pathophysiological mechanisms have been described that are common to renal carcinoma and multiple myeloma; in particular, the role of interleukin-6, which is produced by the renal cells and stimulates the proliferation of myeloma cells. Clinicians must be aware of the possibility of this disease combination and, in the event of an obvious recurrence of one of these two diseases, should search systematically for recurrence of the other disease.
两种癌症同时出现在单个患者身上的情况较为罕见。通常情况下，第二种癌症是由第一种肿瘤的治疗（化疗、放疗）引起的免疫抑制导致的。多发性骨髓瘤和肾癌具有相似的危险因素（肥胖、吸烟、高血压），文献中已经描述了几例这两种肿瘤同时存在的情况。我们首次报告了两个临床病例，涉及多发性骨髓瘤和透明细胞肾细胞癌同时发现，在初始诊断后一段时间，伴有骨骼复发。已经描述了一些与肾癌和多发性骨髓瘤共同存在的病理生理机制；特别是，由肾细胞产生并刺激骨髓瘤细胞增殖的白细胞介素-6的作用。临床医生必须意识到这种疾病组合的可能性，如果这两种疾病中的一种明显复发，应该系统地搜索另一种疾病的复发。
