Familial Cancer

, Volume 12, Issue 3, pp 397–402 | Cite as

Diagnosis and management of BHD-associated kidney cancer

  • Lambros Stamatakis
  • Adam R. Metwalli
  • Lindsay A. Middelton
  • W. Marston Linehan
Original Article

Abstract

In addition to the associated cutaneous and pulmonary manifestations, individuals with the Birt-Hogg-Dubé (BHD) syndrome have an increased risk of developing kidney cancer, which is often bilateral and multifocal. The risk of developing a renal tumor in this population does not decrease with age and therefore warrants a lifelong screening approach. We recommend abdominal imaging every 36 months in individuals without renal lesions at initial screening. Once renal tumors are identified, they should be followed with interval imaging studies until the largest tumor reaches 3 cm in maximal diameter, at which point nephron-sparing surgery should be ideally pursued. While the histology of renal tumors can vary in the BHD syndrome, most tumors possess a relatively indolent natural history and do not require adjuvant therapy if resected when localized to the kidney. With this approach, the vast majority of patients will achieve a curative oncologic outcome and avoid the medical sequelae of chronic renal insufficiency that could otherwise result from total nephrectomy.

Keywords

Birt-Hogg-Dubé Clinical Management Syndrome Kidney cancer BHD Renal cell carcinoma 

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Copyright information

© Springer Science+Business Media Dordrecht (outside the USA) 2013

Authors and Affiliations

  • Lambros Stamatakis
    • 1
  • Adam R. Metwalli
    • 1
  • Lindsay A. Middelton
    • 1
  • W. Marston Linehan
    • 1
  1. 1.Urologic Oncology Branch, Center for Cancer ResearchNational Cancer InstituteBethesdaUSA

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