TFE3-positive renal cell carcinoma occurring in three children with dysfunctional kidneys on immunosuppression

Pediatr Transplant. 2017 Jun;21(4). doi: 10.1111/petr.12912. Epub 2017 Mar 21.

Abstract

Pediatric RCC is a rare pediatric neoplasm and is distinctly different compared to adult RCC, often demonstrating translocation morphology evidenced by unique histopathological features and TFE3 or TFEB nuclear expression. We report three cases of pediatric TFE3 positive RCC (TFE3-RCC) occurring in the setting of chronic kidney disease and long-term pharmacological immunosuppression, including two cases that developed in the native kidney following kidney transplantation. Together, these cases suggest that the kidney microenvironment in combination with immune dysregulation is likely contributing factors in the pathogenesis of some pediatric RCC, warranting further study. Long-term post-transplant surveillance may warrant screening for RCC.

Keywords: TFE3-positive RCC; pediatric renal transplant; renal cell carcinoma.

Publication types

  • Case Reports

MeSH terms

  • Basic Helix-Loop-Helix Leucine Zipper Transcription Factors / metabolism*
  • Biomarkers, Tumor / metabolism*
  • Carcinoma, Renal Cell / diagnosis*
  • Carcinoma, Renal Cell / etiology
  • Carcinoma, Renal Cell / metabolism
  • Child
  • Fatal Outcome
  • Female
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Infant
  • Kidney Failure, Chronic / surgery*
  • Kidney Neoplasms / diagnosis*
  • Kidney Neoplasms / etiology
  • Kidney Neoplasms / metabolism
  • Kidney Transplantation*
  • Male
  • Postoperative Complications / diagnosis*
  • Postoperative Complications / etiology
  • Postoperative Complications / metabolism
  • Tumor Microenvironment

Substances

  • Basic Helix-Loop-Helix Leucine Zipper Transcription Factors
  • Biomarkers, Tumor
  • Immunosuppressive Agents
  • TFE3 protein, human