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Zhang H, Wu W, Wu S, Teng X. Primary mucinous tumors of the renal pelvis: Clinical, histopathological, and molecular analysis of three cases. Ann Diagn Pathol 2024; 72:152325. [PMID: 38733673 DOI: 10.1016/j.anndiagpath.2024.152325] [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: 03/07/2024] [Revised: 05/05/2024] [Accepted: 05/07/2024] [Indexed: 05/13/2024]
Abstract
Primary mucinous tumors of the renal pelvis are extremely rare and pose challenges in terms of diagnosis and treatment. This study reviewed the clinical and pathological characteristics of mucinous tumors of the renal pelvis, including mucinous cystadenocarcinomas and mucinous cystadenomas. Immunohistochemical analysis was conducted in three cases, along with KRAS gene detection using the Amplification Refractory Mutation System (ARMS) method. The results revealed mucinous epithelium with acellular mucinous pools in all cases, and acellular mucinous pools were observed in the renal parenchyma and perirenal fat capsules. All tumors expressed CK20 and CDX2, and one case showed KRAS gene mutation. The study suggests that mucinous cystadenomas of the renal pelvis may exhibit borderline biological behaviors. This study is the first to report a KRAS gene mutation in a mucinous cystadenoma of the renal pelvis, offering valuable insights into the diagnosis and treatment of this rare condition.
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Affiliation(s)
- Huifang Zhang
- Department of Pathology, The First Affiliated Hospital, College of Medicine, Zhejiang University, 310000 Hangzhou, Zhejiang Province, China
| | - Weiqiang Wu
- Department of Pathology, The First Affiliated Hospital, College of Medicine, Zhejiang University, 310000 Hangzhou, Zhejiang Province, China
| | - Shanshan Wu
- Department of Pathology, Taizhou Hospital of Zhejiang Province affliated to Wenzhou Medical University, 318000 Taizhou, Zhejiang Province, China
| | - Xiaodong Teng
- Department of Pathology, The First Affiliated Hospital, College of Medicine, Zhejiang University, 310000 Hangzhou, Zhejiang Province, China.
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Wu S, Yao H, Li Z, Shi P, Tang X, Zhang W, Ding X, Li S. 'Case of the Month' from Zhongnan Hospital, Wuhan University, China: mucinous cystadenoma of the renal pelvis. BJU Int 2024; 133:403-406. [PMID: 38303552 DOI: 10.1111/bju.16275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Affiliation(s)
- ShaoJie Wu
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Hongmei Yao
- Department of Ophthalmology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - ZhiLong Li
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Peng Shi
- Department of Urology, Xianning First People's Hospital, Xianning, China
| | - XiaoYu Tang
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Weibing Zhang
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xiegang Ding
- Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Sheng Li
- Cancer Precision Diagnosis and Treatment and Translational Medicine Hubei Engineering Research Center, Zhongnan Hospital of Wuhan University, Wuhan, China
- Department of Biological Repositories, Zhongnan Hospital of Wuhan University, Wuhan, China
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Li D, Zhang W, Wang J, Wang A, Wu M, Wei Y. Nephron-sparing surgery for primary mucinous adenocarcinoma of renal pelvis in horseshoe kidney: A case report. Medicine (Baltimore) 2023; 102:e33410. [PMID: 36961136 PMCID: PMC10035991 DOI: 10.1097/md.0000000000033410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 03/10/2023] [Indexed: 03/25/2023] Open
Abstract
RATIONALE Mucinous adenocarcinoma of the renal pelvis is extremely rare in malignancy of the renal pelvis, and <100 cases have been reported so far. However, horseshoe kidneys appear to be more prone to this mucinous gland metaplasia. Due to the lack of a specific diagnostic basis, it is difficult to confirm the diagnosis before surgery, which is easy to cause misdiagnosis. PATIENT CONCERNS We report a 64-year-old male patient who found a cystic mass in the left kidney during physical examination. CT examination showed a horseshoe kidney with a cystic mass 9.5 × 8.0 cm in front of the left kidney, lacking obvious diagnostic features. DIAGNOSIS It was misdiagnosed as cystic teratoma before the operation, and was diagnosed as mucinous adenocarcinoma of the renal pelvis through pathological examination after the operation. INTERVENTIONS Resection of the tumor by nephron-sparing surgery and postoperative chemotherapy. OUTCOMES No tumor recurrence was found at 6 years of follow-up. After 7 years, the patient had multiple metastases in the abdominal wall and peritoneum, and no tumor recurrence was found in the urinary system. The patient received chemotherapy again and survived well. LESSONS The prognosis of nephron-sparing tumor resection for MRAP is not significantly different from that of radical nephroureterectomy + bladder cuff excision. Because it can reduce the risk that patients can not tolerate follow-up chemotherapy due to abnormal renal function after surgery, which may be more beneficial in patients with kidney abnormalities or chronic disease.
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Affiliation(s)
- Dapeng Li
- Department of Urology, Rongcheng People’s Hospital, The Affiliated Hospital of Jining Medical University, Weihai, Shandong, China
| | - Wei Zhang
- Department of Urology, Rongcheng People’s Hospital, The Affiliated Hospital of Jining Medical University, Weihai, Shandong, China
| | - Jun Wang
- Department of Urology, Rongcheng People’s Hospital, The Affiliated Hospital of Jining Medical University, Weihai, Shandong, China
| | - An Wang
- Department of Urology, Rongcheng People’s Hospital, The Affiliated Hospital of Jining Medical University, Weihai, Shandong, China
| | - Mingming Wu
- Department of Urology, Rongcheng People’s Hospital, The Affiliated Hospital of Jining Medical University, Weihai, Shandong, China
| | - Yangguang Wei
- Department of Urology, Rongcheng People’s Hospital, The Affiliated Hospital of Jining Medical University, Weihai, Shandong, China
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Kalantari M, Kalantari S, Mottaghi M, Aghaee A, Soltani S, Pedram Rad B. Parenchymal mucinous cystadenoma of the kidney: a case report and literature review. AFRICAN JOURNAL OF UROLOGY 2021. [DOI: 10.1186/s12301-021-00203-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Mucinous cystadenoma (MC) of the kidney is exceedingly rare. We found 22 similar cases in the literature. These masses are underdiagnosed due to radiologic similarities with simple renal cysts.
Case presentation
A 66-year-old man with a previous history of hypertension and anxiety was referred to our tertiary clinic with left flank pain. Ultrasound revealed a 60 mm-sized, complex cystic mass with irregular septa in the lower pole of the left kidney (different from last year's sonographic findings of a simple benign cyst with delicate septa). CT scan showed the same results plus calcification. Due to suspected renal cell carcinoma, a radical nephrectomy was performed. Postoperative histopathologic examination revealed a cyst lined by a single layer of columnar mucin-producing cells with small foci of pseudo-stratification, consistent with the MC’s diagnosis. The first follow-up visit showed normal blood pressure without medication and no flank pain and anxiety after a month.
Conclusion
It is quite challenging to distinguish the primary MC of the kidney from a simple renal cyst based on clinical and imaging findings. The radiologic features of these entities overlap significantly. Thus, complex renal cyst and renal cysts with mural nodules should be followed closely to detect malignancy earlier.
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Ren K, Gou X. Cystic nephroma: A bosniak III benign tumor in the kidney. Asian J Urol 2021; 8:243-245. [PMID: 33996485 PMCID: PMC8099650 DOI: 10.1016/j.ajur.2020.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 04/27/2019] [Accepted: 07/15/2019] [Indexed: 11/01/2022] Open
Affiliation(s)
- Ke Ren
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xin Gou
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Li H, Xie F, Zhao C, Yi Z, Chen J, Zu X. Primary mucinous adenocarcinoma of the renal pelvis misdiagnosed as calculous pyonephrosis: a case report and literature review. Transl Androl Urol 2020; 9:781-788. [PMID: 32420184 PMCID: PMC7214977 DOI: 10.21037/tau.2019.12.38] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Primary mucinous adenocarcinoma of the renal pelvis is a rare malignant disease that is difficult to diagnose preoperatively. There are still no characteristic symptoms, radiological features, or standard treatment for this tumor with only ~100 cases reported. The prognosis is poor. We report a case of a 66-year-old man who presented with a 2-month history of fever and right waist pain. He was misdiagnosed with calculous pyonephrosis and underwent percutaneous nephrostomy (PCN) at a local hospital. Gelatinous material was drained via a PCN catheter. He was then transferred to our hospital. He had elevated CEA and CA19-9. We performed an open radical nephrectomy and found polypoid, gelatinous material and stones filling the renal pelvis. He was diagnosed with primary mucinous adenocarcinoma of the renal pelvis by pathology. He refused adjuvant chemotherapy and there was no sign of recurrence after one year of follow-up. By assessing a literature review of all of the cases reported since 2000, we recommend that careful history taking, serum tumor markers, and CT scans may improve the diagnostic accuracy rates and radical nephrectomy with total ureterectomy accompanied by adjuvant therapy may improve the prognosis.
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Affiliation(s)
- Huihuang Li
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Fujuan Xie
- Department of Surgery, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Cheng Zhao
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Zhenglin Yi
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Jinbo Chen
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Xiongbing Zu
- Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China
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Baka K, Guedira H, Lakmichi M, Dahami Z, Moudouni S, Sarf I. Hydronéphrose géante révélant un cystadénome mucineux de la voie excrétrice urinaire supérieure. AFRICAN JOURNAL OF UROLOGY 2016. [DOI: 10.1016/j.afju.2016.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Mitome T, Yao M, Udaka N, Fusayasu S, Izumi K, Osaka K, Hayashi N, Nakaigawa N, Nagashima Y, Kubota Y. Mucinous cystadenoma of a horseshoe kidney: A case report and literature review. Can Urol Assoc J 2015; 9:E30-2. [PMID: 25624964 DOI: 10.5489/cuaj.2211] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
A 45-year-old man complained of a palpable mass in his left abdomen. Computed tomography showed a horseshoe kidney with a Bosniak type II complicated cyst from a left segment. Three years after his initial examination, due to the growing cystic lesion and the compression imposed on the urinary collecting system and surrounding organs, we performed a left heminephrectomy. The diagnosis was mucinous cystadenoma of the kidney. No recurrence was observed 6 months after surgery. The histopathology was unique since the inner surface of the cyst was covered by a mucin-positive columnar epithelium connected to a urothelium, with continuous transition between the two. This suggests that the mucinous tumour may have originated from a sequestered segment of the renal pelvic epithelium in the renal parenchyma.
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Affiliation(s)
- Taku Mitome
- Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Masahiro Yao
- Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Naoko Udaka
- Department of Pathology, Yokohama City University Hospital, Yokohama, Kanagawa, Japan
| | - Shusei Fusayasu
- Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Koji Izumi
- Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Kimito Osaka
- Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Narihiko Hayashi
- Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Noboru Nakaigawa
- Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Yoji Nagashima
- Department of Molecular Pathology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Yoshinobu Kubota
- Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
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