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Sakr M, Badran M, Hassan SA, Elsaqa M, Elwany MA, Deeb NMFE, Sharafeldeen M. Detection of two synchronous histologically different renal cell carcinoma subtypes in the same kidney: a case report and review of the literature. J Med Case Rep 2024; 18:250. [PMID: 38760853 PMCID: PMC11102143 DOI: 10.1186/s13256-024-04527-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Accepted: 03/27/2024] [Indexed: 05/19/2024] Open
Abstract
INTRODUCTION Renal cell carcinoma (RCC) is the dominant primary renal malignant neoplasm, encompassing a significant portion of renal tumors. The presence of synchronous yet histologically distinct ipsilateral RCCs, however, is an exceptionally uncommon phenomenon that is rather under-described in the literature regarding etiology, diagnosis, management, and later outcomes during follow-up. CASE PRESENTATION We aim to present the 9th case of a combination chromophobe RCC (ChRCC) and clear cell RCC (ccRCC) in literature, according to our knowledge, for a 69-year-old North African, Caucasian female patient who, after complaining of loin pain and hematuria, was found to have two right renal masses with preoperative computed tomography (CT) and underwent right radical nephrectomy. Pathological examination later revealed the two renal masses to be of different histologic subtypes. CONCLUSION The coexistence of dissimilar RCC subtypes can contribute to diverse prognostic implications. Further research should focus on enhancing the complex, yet highly crucial, preoperative detection and pathological examination to differentiate multiple renal lesions. Planning optimal operative techniques (radical or partial nephrectomy), selecting suitable adjuvant regimens, and reporting long-term follow-up outcomes of patients in whom synchronous yet different RCC subtypes were detected are of utmost importance.
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Affiliation(s)
- Mohamed Sakr
- Faculty of Medicine, Alexandria University, Champollion Street, Alexandria, Egypt
| | - Merhan Badran
- Faculty of Medicine, Alexandria University, Champollion Street, Alexandria, Egypt.
| | - Sarah Ahmed Hassan
- Faculty of Medicine, Alexandria University, Champollion Street, Alexandria, Egypt
| | - Mohamed Elsaqa
- Faculty of Medicine, Alexandria University, Champollion Street, Alexandria, Egypt
| | - Mohamed Anwar Elwany
- Faculty of Medicine, Alexandria University, Champollion Street, Alexandria, Egypt
| | - Nevine M F El Deeb
- Faculty of Medicine, Alexandria University, Champollion Street, Alexandria, Egypt
| | - Mohamed Sharafeldeen
- Faculty of Medicine, Alexandria University, Champollion Street, Alexandria, Egypt
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Belle Mbou V, Sanglier F, Pestre-Munier J, Descazeaud A, Labrousse F. Renal collision tumours: three additional case reports. BMC Urol 2022; 22:113. [PMID: 35870918 PMCID: PMC9308929 DOI: 10.1186/s12894-022-01063-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 07/13/2022] [Indexed: 11/10/2022] Open
Abstract
Background Multiple kidney tumours are frequently seen in hereditary syndromes and familial diseases. Renal collision tumours (RCT) are characterized by the simultaneous existence of different and unrelated tumour types within the same location in the kidney, forming a single, heterogenous lesion. RCT are uncommon histological entities with distinctive features. The most frequent subtypes include clear cell renal cell carcinoma (CCRCC), papillary renal cell carcinoma (PRCC), chromophobe renal cell carcinoma (CRCC), and collecting duct carcinoma (CDC). Case presentation Here, we report three sporadic cases of RCT successfully treated by nephrectomy and confirmed by histological analysis. The first case was of a 64-year-old man diagnosed with RCT composed of a stage 2 nucleolar grade 3 CCRCC and a stage 1a nucleolar grade 2 type 1 PRCC. The second case was of a 68-year-old woman diagnosed with a combined nucleolar grade 2 type 1 PRCC and an angiomyolipoma (non-assessed stage), while the third case was of a 59-year-old woman diagnosed with a combined stage 1a nucleolar grade 3 CCRCC and a stage 1b CDC. Conclusions Due to the rarity of RCT, there are no standard guidelines for their management. Hence, the prognosis is considered to be associated with the most aggressive component, possibly the tumour with the highest nucleolar grade and stage. The histogenesis of RCT remains debated, and increase in knowledge regarding this can help enable the development of targeted therapies for advanced or metastatic tumours.
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Cimadamore A, Lopez-Beltran A, Scarpelli M, Cheng L, Montironi R. The Wide Spectrum of Oncocytic Changes and Tumors in the Kidney: Splitting and Lumping. Pathobiology 2021; 88:323-326. [PMID: 33975322 DOI: 10.1159/000516046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 03/17/2021] [Indexed: 11/19/2022] Open
Affiliation(s)
- Alessia Cimadamore
- Section of Pathological Anatomy, Polytechnic University of the Marche Region, School of Medicine, United Hospitals, Ancona, Italy
| | | | - Marina Scarpelli
- Section of Pathological Anatomy, Polytechnic University of the Marche Region, School of Medicine, United Hospitals, Ancona, Italy
| | - Liang Cheng
- Department of Pathology and Laboratory Medicine, School of Medicine, Indiana University, Indianapolis, Indiana, USA
| | - Rodolfo Montironi
- Section of Pathological Anatomy, Polytechnic University of the Marche Region, School of Medicine, United Hospitals, Ancona, Italy
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Arık D, Açıkalın MF, Can C. Papillary renal cell carcinoma and collecting duct carcinoma combination. A case report and review of synchronous renal cell carcinoma subtypes in the same kidney. Arch Med Sci 2015; 11:686-90. [PMID: 26170866 PMCID: PMC4495165 DOI: 10.5114/aoms.2015.52378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Revised: 02/12/2014] [Accepted: 02/18/2014] [Indexed: 11/18/2022] Open
Affiliation(s)
- Deniz Arık
- Department of Pathology, Faculty of Medicine, Eskisehir Osmangazi University, Eskişehir, Turkey
| | - Mustafa Fuat Açıkalın
- Department of Pathology, Faculty of Medicine, Eskisehir Osmangazi University, Eskişehir, Turkey
| | - Cavit Can
- Department of Urology, Faculty of Medicine, Eskisehir Osmangazi University, Eskişehir, Turkey
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Chen S, Jin B, Xu L, Fu G, Meng H, Liu B, Li J, Xia D. Cystic renal cell carcinoma: a report of 67 cases including 4 cases with concurrent renal cell carcinoma. BMC Urol 2014; 14:87. [PMID: 25381150 PMCID: PMC4233089 DOI: 10.1186/1471-2490-14-87] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Accepted: 10/23/2014] [Indexed: 01/06/2023] Open
Abstract
Background Cystic renal cell carcinoma (CRCC) is relatively rare; CRCC is frequently misdiagnosed as a benign renal cyst. CRCC carries an excellent prognosis following surgical treatment. The aim of our study was to summarize the management of CRCC and to characterize the prognosis of affected patients. Methods A retrospective study of 67 patients with CRCC was conducted at our center between January 2005 and April 2013. Patient prognosis as well as the clinical manifestations, imaging characteristics, treatment, and pathologic features of CRCC were summarized based on available medical record data. Results We identified 67 cases of CRCC, representing 2.5% of all renal cell carcinoma cases. The tumor was discovered incidentally in 70% of the cases. Ultrasonography was found to be a useful screening tool, but computed tomography remains the imaging study of choice for identifying malignant features. Magnetic resonance imaging can be used in equivocal cases. Regarding treatment, radical nephrectomy was performed in 52% of the cases, and partial nephrectomy was selected in the remaining 48% of cases. None of the 46 patients (68% of the study group) available for follow-up showed any evidence of recurrence. Conclusions CRCC is an uncommon subtype of renal cell carcinoma, occurring in 2.5% of cases. CRCC carries an excellent prognosis after surgical treatment. Partial nephrectomy should be regarded as the preferred surgical technique for CRCC.
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Affiliation(s)
| | - Baiye Jin
- Departments of Urology, The First Affiliated Hospital, Medical School of Zhejiang University, Hangzhou, Zhejiang 310031, P,R, China.
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Burch-Smith R, Tannir NM, Resetkova E, Tamboli P, Rao P. Collision tumor of the kidney composed of clear cell carcinoma and collecting duct carcinoma: report of a case with unusual morphology and clinical follow-up. CHINESE JOURNAL OF CANCER 2014; 33:351-5. [PMID: 24589208 PMCID: PMC4110468 DOI: 10.5732/cjc.013.10155] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We report the case of a 67-year-old female who presented with a large renal mass. Gross examination of the nephrectomy specimen demonstrated a 6-cm renal mass that invaded into the renal sinus and perinephric fat. Histologic examination revealed two distinct tumor types. The first type was a conventional (clear cell) renal cell carcinoma that was of low nuclear grade and comprised the minority of the overall tumor. The second type was a high-grade collecting duct carcinoma with glandular/tubular differentiation and composed the majority of the tumor. Immunohistochemical studies demonstrated distinctive patterns of the two tumor types, thus confirming two distinct lineages. Five months postoperatively, the patient developed metastasis to the lungs and right hilar lymph node region. A fine needle aspiration of a lung nodule demonstrated a metastatic, poorly differentiated carcinoma, similar to the collecting duct carcinoma component in the kidney. Collision tumors of the kidney are rare with fewer than 10 cases reported in the literature. Our report further expands the spectrum of this rare phenomenon.
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Affiliation(s)
- Rhonda Burch-Smith
- Department of Pathology, MD Anderson Cancer Center, Houston, TX 77030, USA.
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Coexistence of a colon carcinoma with two distinct renal cell carcinomas: a case report. J Med Case Rep 2011; 5:134. [PMID: 21463521 PMCID: PMC3078860 DOI: 10.1186/1752-1947-5-134] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2010] [Accepted: 04/04/2011] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION We present the case of a patient with two tumors in his left kidney and a synchronous colon cancer. While coexisting tumors have been previously described in the same kidney or the kidney and other organs, or the colon and other organs, to the best of our knowledge no such concurrency of three primary tumors has been reported in the literature to date. CASE PRESENTATION A 72-year-old man of Greek nationality presenting with pain in the right hypochondrium underwent a series of examinations that revealed gallstones, a tumor in the hepatic flexure of the colon and an additional tumor in the upper pole of the left kidney. He was subjected to a right hemicolectomy, left nephrectomy and cholecystectomy, and his postoperative course was uneventful. Histopathology examinations showed a mucinous colon adenocarcinoma, plus two tumors in the left kidney, a papillary renal cell carcinoma and a chromophobe renal cell carcinoma. CONCLUSION This case underlines the need to routinely scan patients pre-operatively in order to exclude coexisting tumors, especially asymptomatic renal tumors in patients with colorectal cancer, and additionally to screen concurrent tumors genetically in order to detect putative common genetic alterations.
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Kang SG, Ko YH, Kang SH, Kim J, Kim CH, Park HS, Moon DG, Lee JG, Kim JJ, Cheon J. Two different renal cell carcinomas and multiple angiomyolipomas in a patient with tuberous sclerosis. Korean J Urol 2010; 51:729-32. [PMID: 21031096 PMCID: PMC2963789 DOI: 10.4111/kju.2010.51.10.729] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2010] [Accepted: 08/17/2010] [Indexed: 11/18/2022] Open
Abstract
We report a case of tuberous sclerosis associated with two histologically different renal cell carcinomas (RCCs) and multiple angiomyolipomas (AMLs) in the same kidney. A 43-year-old female was admitted to our hospital with left flank pain and a huge palpable mass in the left flank area. Abdominal computed tomography revealed two concurrent RCCs and multiple AMLs in the left kidney. Because of the clinical suspicion of RCC, the patient underwent left radical nephrectomy. On gross examination, the total size of the resected left kidney was 30.5×17×8 cm. Microscopically, the upper pole tumor features were consistent with chromophobe RCC and the midpole tumor was a clear-cell RCC. The multifocal masses in the remaining remnant parenchyma were AMLs. Six months after surgery, the patient is healthy without signs of tumor recurrence.
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Affiliation(s)
- Sung Gu Kang
- Department of Urology, Korea University School of Medicine, Seoul, Korea
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Tyritzis SI, Alexandrou PT, Migdalis V, Koritsiadis G, Anastasiou I. Synchronous chromophobe and papillary renal cell carcinoma. First report and review of the pathogenesis theories. Pathol Int 2009; 59:193-6. [PMID: 19261099 DOI: 10.1111/j.1440-1827.2009.02350.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The coexistence of different subtypes of renal cell carcinoma (RCC) within a single kidney is an extremely unusual entity. Presented herein is the case of a 57-year-old man with two RCC of chromophobe and papillary histology. Very few reports in the literature describe double or triple synchronous renal neoplasms. To our knowledge this is the first report of this RCC subtype combination, which might trigger further investigation on the RCC pathogenesis theories.
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Mazzucchelli R, Cheng L, Lopez-Beltran A, Scarpelli M, Montironi R. Renal oncocytosis and multiple papillary adenomas with oncocytoma as dominant nodule coexisting with papillary carcinoma in a patient with diabetic glomerulosclerosis, acquired renal cystic disease and B cell lymphoma. APMIS 2008; 116:934-8. [DOI: 10.1111/j.1600-0463.2008.01090.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Masuzawa N, Kishimoto M, Nishimura A, Shichiri Y, Yanagisawa A. Oncocytic renal cell carcinoma having papillotubular growth: Rare morphological variant of papillary renal cell carcinoma. Pathol Int 2008; 58:300-5. [DOI: 10.1111/j.1440-1827.2008.02227.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Affiliation(s)
- Amber A Petrolla
- Institute of Pathology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, Ohio, USA
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