[Non-Hodgkin's lymphoma, renal carcinoma, and meningioma. A clinical case].
Some second malignant neoplasms are increasingly being observed following NHL and a considerable amount of data has accumulated in the literature. The authors describe a case of 65-year old male who presented with submandibular adenopathy. Results of a biopsy of the mass surgically removed revealed low grade non-Hodgkin lymphoma. During the staging workup, a meningioma and a renal cell adenocarcinoma (RCC) were unexpectedly discovered and successively resected. The patient is currently alive with no evidence of metastatic diseases 12 months after diagnosis of non-Hodgkin's lymphoma (NHL), 10 months after meningioma resection and 8 months after RCC resection. The possibility of an underlying pathologic mechanism predisposing to multiple tumours should be considered. RCC and central nervous system (CNS) neoplasms are among second malignancies with higher incidences in non-Hodgkin lymphoma patients whereas with specific regard to meningioma, one of the most common benign intracranial tumours that sometimes shows biological aggressiveness and malignancy, we have currently no data in the literature. Increased risks for several malignancies occur late in the NHL follow-up period and are largely confined to patients receiving either radiation therapy or chemotherapy. On the other hand, increased risks for renal cancer have also been reported at less than one year after diagnosis of NHL and are present in all treatment subgroups (radiation therapy, chemotherapy, other-no treatment). Increased risks for CNS malignant neoplasms have also been reported at less than one year. The authors review the pathogenic significance of this case report neoplasms association in the light of the various explicative hypothesis of this concurrence. Possible immune mechanisms associated with these neoplasm are particularly pointed up.