A Case of Advanced Renal Cell Carcinoma With Concomitant Development of Multiple Endocrine Neoplasia Type 1 That Affected Treatment Progress With Immunotherapy

Abstract

Introduction

Hypercalcemia is a poor prognostic factor in advanced cancer.

Case Presentation

A patient with advanced clear cell renal carcinoma with hypercalcemia was treated with nivolumab+ipilimumab combination therapy. Treatment was discontinued after 4 months due to renal dysfunction. A detailed examination showed that the cause of hypercalcemia was hyperparathyroidism caused by multiple endocrine neoplasia type 1, and that renal dysfunction was attributed to the administration of zoledronic acid for the management of hypercalcemia. Following the suspension of cancer treatment, both the primary and metastatic lesions continued to shrink. A deferred nephrectomy was performed, and a pathological examination showed the absence of viable cancer cells in the specimen. Approximately 5 years after treatment, the patient is alive and cancer-free without treatment.

Conclusion

Hypercalcemia due to hyperparathyroidism had an impact on treatment in this case. This underscores the importance of meticulous patient history-taking in medical practice.