Development of crizotinib-associated renal cyst in a non-small cell lung cancer patient with ALK fusion: a case report and review of the literature

Diagn Pathol. 2024 Apr 14;19(1):58. doi: 10.1186/s13000-024-01480-7.

Abstract

Background: Crizotinib, an oral first-generation tyrosine kinase inhibitor (TKI), is superior to systemic chemotherapy for the treatment of non-small cell lung cancer (NSCLC) with positive rearrangement of anaplastic lymphoma kinase (ALK). However, an increased incidence of renal and hepatic cysts has been reported in the patients on crizotinib treatment.

Case presentation: Here, we describe a case of a 71-year-old Chinese women developed multiple cystic lesions in kidney and liver during crizotinib treatment for the primary and metastatic NSCLC. The renal and hepatic cysts were noted by CT scan 3 months after crizotinib treatment, which were spontaneously and significantly regressed after stopping crizotinib.

Conclusions: Based on literature review and our experience in this case report, we concluded that crizotinib-associated renal cyst (CARCs) has features of malignancy and abscess in radiographic imaging, and thus, pathological confirmation is necessary to avoid inappropriate treatment decision. In addition, to benefit the patients with progress-free survival (PFS), switching from crizotinib to alectinib is recommended for the treatment of NSCLC patients who developed CARCs.

Keywords: Case report; Crizotinib; Crizotinib-associated renal cyst; Non-small cell lung cancer.

Publication types

  • Review
  • Case Reports

MeSH terms

  • Aged
  • Anaplastic Lymphoma Kinase / genetics
  • Carcinoma, Non-Small-Cell Lung* / drug therapy
  • Carcinoma, Non-Small-Cell Lung* / genetics
  • Crizotinib / adverse effects
  • Cysts* / chemically induced
  • Female
  • Humans
  • Kidney Diseases, Cystic* / chemically induced
  • Kidney Diseases, Cystic* / diagnosis
  • Kidney Diseases, Cystic* / genetics
  • Lung Neoplasms* / drug therapy
  • Lung Neoplasms* / genetics

Substances

  • Crizotinib
  • Anaplastic Lymphoma Kinase