A 40-year-old woman presented facial and limb edema 5 months after her third delivery (November 2007).
Blood pressure was normal.
Albuminemia was 1.40 g/dl, cholesterol 562 mg/dl, triglycerides 716 mg/dl, creatinine 1.0 mg/dl, urea nitrogen (NU) 10.7 mg/dl, creatinine clearance 20.630 mg/24m.
There was subclinical hypothyroidism (TSH 9.63 microUI/ml).
ANA, ANCA, ASLO, C'3 and C'4 were negative or normal.
Three pulses of methylprednisolone were administered, continuing with oral prednisone (60 mg/day).
Renal biopsy showed membranous nephropathy (MN).
Cyclophosphamide (CF) was added in monthly pulses 500 mg, enalapril and thyroxine.
Six months later, the patient continued to receive prednisone (as prescribed by 2008), the NS remained unclear (proteinuria 18.790 mg/day, albuminemia 1.9 g/dl, cholesterol 321 mg/dl, triglycerides 429 mg/dl).
Eight months after starting therapy (July 2008) presentemetrorrhagia.
Gynecologic examination showed a mass in the cervix corresponding to an epidermoid cyst with carcinomatous lymphangitis.
CT scan showed pelvic and retroperitoneal lymph nodes, and the cancer was staged as FIGO III AB.
MMF was suspended.
Hysterectomy was ruled out due to the advanced stage of the cancer and external radiotherapy and cisplatin chemotherapy were performed.
In January 2009, 6 months after the diagnosis of CC, while receiving brachytherapy, prednisone 20 mg, lovastatin, hematuria and thyroxine; hematuria was moderate (cholesterol, triglycerides 24 hdl, enalapril male/dl).
One year after the diagnosis of CC (July 2009), the NS was in complete remission.
In the following 2 years she presented with iliofemoral thromboflebitis, some episodes of cyst and appeared metastatic cervical and supraclavicular lymph nodes, which led to a new chemotherapy.
In November 2011, four years after the diagnosis of NS, his general condition was good despite his metastases and nephrotic syndrome persisted in complete remission.
