Zalewska Ewa, Obołończyk Łukasz, Sworczak Krzysztof
Department of Endocrinology and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland.
Front Oncol. 2021 Mar 24;11:639395. doi: 10.3389/fonc.2021.639395. eCollection 2021.
Renal cell cancer may cause various paraneoplastic syndromes; however, paraneoplastic hypereosinophilia occurs exceedingly rare. Thus far, only two cases of clear cell renal cell carcinoma (CCRCC) associated with hypereosinophilia have been reported. In this paper, we present a case of paraneoplastic hypereosinophilia associated with renal cell carcinoma and a review of the reported cases of hypereosinophilia in solid tumors.
The review is based on an electronic literature search performed in the PubMed database in September 2020 with the following key terms: eosinophilia & neoplasm; eosinophilia & cancer; eosinophilia & paraneoplastic syndrome. Papers were included based on screening the titles and/or abstracts. We also included the case of our patient in the analysis.
A 68-year-old Caucasian female patient with recurrent CCRCC was admitted to our Clinic for exacerbating dyspnea and chest and right upper abdominal pain, accompanied by confusion. Preliminary blood tests showed an increased white blood cell count of 40,770/μl, and an increased eosinophil count of 6,530/μl indicating eosinophilia. Several tests were carried out to rule out the noncancer causes of hypereosinophilia. The temporal appearance of eosinophilia and the recurrence of CCRCC without any other apparent potential causes led to the diagnosis of paraneoplastic hypereosinophilia. Despite treating with high doses of corticosteroids, only a transient decrement in eosinophil count was observed along with further deterioration of the patient's condition. The patient succumbed to the disease 6 months following the tumor surgery and 2 months after the diagnosis of hypereosinophilia and tumor recurrence.
Our observations are in agreement with the majority of reports showing that the occurrence of eosinophilia following tumor resection may indicate a poor prognosis, tumor recurrence, and rapid disease progression.
肾细胞癌可能导致各种副肿瘤综合征；然而，副肿瘤性嗜酸性粒细胞增多极为罕见。迄今为止，仅报道了两例与嗜酸性粒细胞增多相关的透明细胞肾细胞癌（CCRCC）。在本文中，我们报告了一例与肾细胞癌相关的副肿瘤性嗜酸性粒细胞增多病例，并对实体瘤中报道的嗜酸性粒细胞增多病例进行了综述。
本综述基于2020年9月在PubMed数据库中进行的电子文献检索，检索关键词如下：嗜酸性粒细胞增多症&肿瘤；嗜酸性粒细胞增多症&癌症；嗜酸性粒细胞增多症&副肿瘤综合征。根据标题和/或摘要筛选纳入文献。我们还将我们患者的病例纳入分析。
一名68岁复发性CCRCC的白种女性患者因呼吸困难加重、胸部和右上腹疼痛并伴有意识模糊入住我院。初步血液检查显示白细胞计数增加至40,770/μl，嗜酸性粒细胞计数增加至6,530/μl，提示嗜酸性粒细胞增多。进行了多项检查以排除嗜酸性粒细胞增多的非癌症原因。嗜酸性粒细胞增多的时间出现以及CCRCC的复发且无任何其他明显潜在原因导致了副肿瘤性嗜酸性粒细胞增多的诊断。尽管使用高剂量皮质类固醇治疗，但仅观察到嗜酸性粒细胞计数短暂下降，同时患者病情进一步恶化。患者在肿瘤手术后6个月以及嗜酸性粒细胞增多和肿瘤复发诊断后2个月死于该疾病。
我们的观察结果与大多数报告一致，表明肿瘤切除后嗜酸性粒细胞增多的发生可能预示预后不良、肿瘤复发和疾病快速进展。
