Tumor-associated glomerulonephritis, mediated by immune complex deposition occurs in carcinoma and hematopoeitic neoplasms but is not described in sarcoma. A 12 year old black girl with chest pain, fever and dyspnea was found to have massive cardiomegaly without murmur or pericardial rub. She also had proteinuria. Pericardiocentesis did not clarify the cardiac lesion. Two months later, cardiac symptoms recurred with pericardial effusion and left ankle swelling. X-ray showed an osteolytic lesion in the distal left tibial metaphysis, later diagnosed as poorly differentiated sarcoma by bone biopsy. Proteinuria was 530 mg/24hr. Renal biopsy revealed proliferative glomerulonephritis granular deposits of IgG and C-3 in glomerular capillary walls and mesangium, and glomerular osmiophilic deposits in subepithelial intramembranous and mesangial zones. Later she developed multiple nodular densities in the lungs and a right sides hemorrhagic pleural effusion. Samples of epicardial tumor implants obtained at thoracotomy revealed telangiectatic osteosarcoma. This pediatric case represents osteosarcoma associated with immune complex proliferative glomerulonephritis.
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Katz, S., Falkner, B. PROLIFERATIVE GLOMERULONEPHRITIS ASSOCIATED WITH OSTEOGENIC SARCOMA. Pediatr Res 14, 996 (1980). https://doi.org/10.1203/00006450-198008000-00137