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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Patients with membranous nephropathy (MN) are known to have an increased risk of malignancy compared with the general population. However, the incidental detection of malignancy within renal biopsy specimens is infrequent. We present a case of MN complicated by clear cell renal cell carcinoma (RCC), which was incidentally identified on renal biopsy during evaluation for nephrotic syndrome.
A 61-year-old man with a history of hypertension, dyslipidemia, cerebral infarction, and epilepsy was referred to our hospital for evaluation of bilateral leg edema and proteinuria. Laboratory findings showed hypoalbuminemia (serum albumin 1.7 g/dL) and heavy proteinuria (12.5 g/gCr), consistent with nephrotic syndrome. Abdominal ultrasonography and other imaging studies revealed no renal masses. A renal biopsy was performed. Light microscopy showed mild thickening of the glomerular basement membrane. Immunofluorescence revealed granular deposits of IgG and C3 along the capillary walls, and electron microscopy demonstrated subepithelial deposits and basement membrane thickening, consistent with MN stage II. Unexpectedly, a cluster of atypical cells with clear cytoplasm was found in a portion of the biopsy specimen, which was pathologically diagnosed as clear cell RCC. Non-contrast CT performed during hospitalization did not reveal any renal mass, and the patient was scheduled for follow-up imaging. Immunosuppressive therapy with prednisolone and cyclosporine was initiated for MN.
The patient was diagnosed with MN complicated by RCC. Although no renal mass was initially detected on imaging, a subsequent contrast-enhanced CT later revealed a small lesion at the biopsy site. Given its small size, active surgical or interventional treatment was considered inappropriate, and a conservative approach was chosen. Under immunosuppressive therapy, the patient’s proteinuria gradually decreased and eventually achieved complete remission. Prednisolone was successfully tapered, and there was no evidence of RCC progression on serial imaging during follow-up.
This case highlights an infrequent clinical scenario in which RCC was incidentally discovered during renal biopsy performed for the evaluation of nephrotic syndrome. The coexistence of MN and malignancy poses a therapeutic dilemma, as immunosuppressive therapy may theoretically promote tumor progression. In this patient, direct intervention for RCC was not feasible, and management consisted of immunosuppressive therapy for MN with careful oncologic surveillance. When RCC is incidentally identified in renal biopsy specimens, regular imaging follow-up remains essential even if no mass is initially visible on imaging.
