HYPERNEPHROMA ASSOCIATED WITH AL AMYLOIDO SIS, NEUROPATHY AND MONOCLONAL GAMMOPATHY

Malignant neoplasms may have secondary (reactive, AA), amyloidosis as a sequel. Among carcinomas, this is most frequent with hypernephroma. We report a 60-year-old male patient with progressive polyneuropathy a nd monoclonal gammopathy of the kappa type. A renal tumor was histolog ically diagnosed as hypernephroma at nephrectomy. The patient did not improve postoperatively and died three and a half months later from pu lmonary embolism. Autopsy revealed a systemic amyloidosis, predominant ly with prominent deposits in peripheral nerves. Immunohistochemical s taining demonstrated the amyloidosis as of the primary (AL) type, rath er than of the expected AA type. A plasmocytoma was not detected, eith er clinically or at autopsy. We assume here a coincidental rather than causal connection between the hypernephroma and the monoclonal gammop athy with AL amyloid and the neuropathy.