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Meliti A, Alardati H, Khayat M, Alruqi A. Combined Clear Cell Renal Cell Carcinoma and Chromophobe Renal Cell Carcinoma: A Case Report. Cureus 2024; 16:e61940. [PMID: 38978897 PMCID: PMC11230612 DOI: 10.7759/cureus.61940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2024] [Indexed: 07/10/2024] Open
Abstract
Renal cell carcinoma (RCC) is a diverse array of cancers arising from renal tubular epithelial cells. RCC presenting with distinct morphological subtypes, such as the simultaneous presence of chromophobe RCC (chRCC) and clear cell RCC (ccRCC) lesions within the same kidney, is rare. We present the case of a 79-year-old female with a history of breast cancer who presented to our facility with right flank pain. Further investigations using CT of the abdomen and pelvis revealed a Bosniak type 4 cyst with a mural nodule in the right kidney. Furthermore, another well-defined, solid lesion measuring 2.8 × 2.6 cm was observed in the same area. The patient underwent a right radical nephrectomy. The macroscopic examination of the kidney revealed the presence of three cysts, with the largest measuring up to 7.5 cm. Moreover, a distinctly demarcated, golden-yellow, solid mass was discerned in the superior pole of the kidney. The mass showed a heterogeneous cut surface with solid and cystic components, measuring 2.8 × 2.6 × 2.0 cm. A less extensive but well-defined, uniform tan mass was also identified within the wall of the largest cyst, which measured 1.2 × 1.0 × 0.7 cm. At this point, the diagnosis of ccRCC and chRCC was established.
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Affiliation(s)
- Abdelrazak Meliti
- Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Centre, Jeddah, SAU
| | - Hosam Alardati
- Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Centre, Jeddah, SAU
| | - Manal Khayat
- Department of Pathology and Laboratory Medicine, King Abdulaziz Medical City, Jeddah, SAU
| | - Abdullah Alruqi
- Department of Pathology and Laboratory Medicine, King Fahad Armed Forces Hospital, Jeddah, SAU
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Bahbahani B, Khan RN, Ahmed I, Al-Rabiy FN, Baqer M, Al-Terki A. Rare renaissance: Quadruple synchronous renal cell tumors in one kidney - A case report. Urol Case Rep 2023; 51:102574. [PMID: 37811540 PMCID: PMC10551615 DOI: 10.1016/j.eucr.2023.102574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 09/22/2023] [Indexed: 10/10/2023] Open
Abstract
Multifocality in renal tumors is a rare occurrence, but not unheard of. Commonly the different foci correspond to the same histological pathology, however co-existence with other renal lesions, including both malignant and benign tumors, have also been reported. Here we present a 57-year-old male, ex-smoker who exhibited four distinct histological tumors in an ipsilateral kidney; multilocular cystic clear cell renal cell carcinoma (RCC) of low malignant potential, clear cell papillary RCC, renal oncocytoma, and renomedullary interstitial cell tumor. To our knowledge this is the first time these four tumors were found in the same patient, let alone the same kidney.
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Affiliation(s)
- Basmah Bahbahani
- Urology Unit – Al Amiri Hospital, PO Box 4077, Safat, 13041, Kuwait
| | - Rehan Nasir Khan
- Urology Unit – Al Amiri Hospital, PO Box 4077, Safat, 13041, Kuwait
| | - Iftikhar Ahmed
- Urology Unit – Al Amiri Hospital, PO Box 4077, Safat, 13041, Kuwait
| | | | - Mohsen Baqer
- Pathology Unit – Al Amiri Hospital, PO Box 4077, Safat, 13041, Kuwait
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Babarasul MH, Bapir R, Rahman DHK, Fakhralddin SS, Kakamad FH, Tahir SH, Ali RM, Abdalla BA, Mohammed SH, Hussein DM. Synchronous ipsilateral papillary renal cell carcinoma and urothelial carcinoma: A case report. Oncol Lett 2023; 25:221. [PMID: 37153050 PMCID: PMC10157353 DOI: 10.3892/ol.2023.13807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 02/14/2023] [Indexed: 05/09/2023] Open
Abstract
Concurrence of renal cell carcinoma (RCC) and urothelial carcinoma (UC) in the same kidney is a rare phenomenon. It is critical to define this unusual disease to avoid a delay in diagnosis and improve the prognosis. The present study describes a case of a 71-year-old patient with synchronous ipsilateral RCC and UC of the renal pelvis and ureter. The patient presented with intermittent attacks of left loin pain with frank hematuria for 3 months and a weight loss of 5 kg over the same period of time. The patient had been a chronic heavy smoker for >45 years. Physical examination revealed stable vital signs; however, a mobile, non-tender mass was palpated in the left upper abdomen. A left nephroureterectomy with the removal of a bladder cuff was performed. Histopathological examination revealed a papillary RCC with a pathological stage of pT1N0Mx and a high-grade UC of the renal pelvis and ureter with a pathological stage of pT3-pN1-pMx. The postoperative recovery was good, and the patient was referred to an oncology center for further management. Previous reports have failed to identify definitive risk factors for the concurrence of RCC and UC. However, 24% of the patients in the various case reports in the literature were smokers. The most common presenting complaints included weight loss and painless hematuria. The concurrence of RCC and UC in the same kidney is a rare entity, and it frequently leads to a worse prognosis than the occurrence of RCC alone. Radical nephroureterectomy is the main line of treatment for patients with upper tract UC.
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Affiliation(s)
- Muhamed Hussen Babarasul
- Department of Urology, Shaheed Shawkat Haji Musheer Hospital, Said Sadiq 46008, Republic of Iraq
| | - Rawa Bapir
- Smart Health Tower, Sulaimani 46000, Republic of Iraq
- Kscien Organization, Sulaimani 46000, Republic of Iraq
- Department of Urology, Sulaymaniyah General Teaching Hospital, Sulaimani 46000, Republic of Iraq
| | | | - Saman Salih Fakhralddin
- Smart Health Tower, Sulaimani 46000, Republic of Iraq
- Department of Urology, Sulaymaniyah General Teaching Hospital, Sulaimani 46000, Republic of Iraq
- College of Medicine, University of Sulaimani, Sulaimani 46000, Republic of Iraq
| | - Fahmi H. Kakamad
- Smart Health Tower, Sulaimani 46000, Republic of Iraq
- Kscien Organization, Sulaimani 46000, Republic of Iraq
- College of Medicine, University of Sulaimani, Sulaimani 46000, Republic of Iraq
- Correspondence to: Dr Fahmi H. Kakamad, College of Medicine, University of Sulaimani, Doctor City, Building 11, Apartment 50, Sulaimani 46000, Republic of Iraq, E-mail:
| | - Soran H. Tahir
- Smart Health Tower, Sulaimani 46000, Republic of Iraq
- College of Medicine, University of Sulaimani, Sulaimani 46000, Republic of Iraq
| | - Rawa M. Ali
- Smart Health Tower, Sulaimani 46000, Republic of Iraq
| | - Berun A. Abdalla
- Smart Health Tower, Sulaimani 46000, Republic of Iraq
- Kscien Organization, Sulaimani 46000, Republic of Iraq
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Narang V, Jindal S, Soni A, Kaur H, Ahluwalia A, Kakkar C, Chahal HS. Synchronous Clear Cell and Papillary Renal Cell Carcinoma: Dual Tumour of Same Kidney. Indian J Surg Oncol 2022; 13:780-782. [PMID: 36687224 PMCID: PMC9845462 DOI: 10.1007/s13193-022-01559-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 05/24/2022] [Indexed: 01/25/2023] Open
Affiliation(s)
- Vikram Narang
- Department of Pathology, Dayanand Medical College & Hospital, Tagore Nagar, Ludhiana, Punjab 141001 India
| | - Saveena Jindal
- Department of Pathology, Dayanand Medical College & Hospital, Tagore Nagar, Ludhiana, Punjab 141001 India
| | - Ankita Soni
- Department of Pathology, Dayanand Medical College & Hospital, Tagore Nagar, Ludhiana, Punjab 141001 India
| | - Harpreet Kaur
- Department of Pathology, Dayanand Medical College & Hospital, Tagore Nagar, Ludhiana, Punjab 141001 India
| | - Archana Ahluwalia
- Department of Radiology, Dayanand Medical College & Hospital, Ludhiana, Punjab India
| | - Chandan Kakkar
- Department of Radiology, Dayanand Medical College & Hospital, Ludhiana, Punjab India
| | - Harmandeep S. Chahal
- Department of Urology, Dayanand Medical College & Hospital, Ludhiana, Punjab India
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Chavez M, Dharia A, Asarian A, Xiao P. Multifocal synchronous renal cell carcinoma of three different histologic subtypes: unusual findings and literature review. J Surg Case Rep 2022; 2022:rjac452. [PMID: 36196127 PMCID: PMC9526544 DOI: 10.1093/jscr/rjac452] [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: 08/25/2022] [Accepted: 09/07/2022] [Indexed: 11/30/2022] Open
Abstract
We present a case of three multifocal synchronous ipsilateral clear cell, papillary type 1 and papillary type 2 renal cell carcinoma (RCC), with papillary type 2 RCC appearing bilaterally. With review of the literature, it was determined that multifocal synchronous RCC subtypes and bilateral renal tumors are both rare in occurrence.
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Affiliation(s)
- Martha Chavez
- Correspondence address. St George’s University School of Medicine, True Blue, Grenada, WI, USA. Tel: 813-551-9287; E-mail:
| | - Ashka Dharia
- Department of Surgery, The Brooklyn Hospital Center, Icahn School of Medicine at Mount Sinai, Brooklyn, NY, USA
| | - Armand Asarian
- Department of Surgery, The Brooklyn Hospital Center, Icahn School of Medicine at Mount Sinai, Brooklyn, NY, USA
| | - Philip Xiao
- Department of Pathology, The Brooklyn Hospital Center, Icahn School of Medicine at Mount Sinai, Brooklyn, NY, USA
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Yin J, Zheng M. Ipsilateral synchronous papillary and clear renal cell carcinoma: A case report and review of literature. World J Clin Cases 2022; 10:5428-5434. [PMID: 35812682 PMCID: PMC9210906 DOI: 10.12998/wjcc.v10.i16.5428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 11/12/2021] [Accepted: 04/24/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND There is limited information on ipsilateral synchronous papillary renal cell carcinoma (PRCC) and clear cell renal cell carcinoma (CCRCC). Therefore, these rare tumors are often misdiagnosed preoperatively as a single tumor with intrarenal metastasis or some other diseases. Effective management and long-term overall survival might be affected because the prognosis of the two tumors differs.
CASE SUMMARY We describe a case of ipsilateral synchronous PRCC and CCRCC with two histological variants in a 72-year-old man, whose mass was found incidentally, with no other chief complaints and vital signs were normal. Initial ultrasound revealed a hypoechoic lobular mass with a volume of 7.8 cm × 4.8 cm × 2.8 cm in the middle to lower pole of the left kidney. A subsequent contrast-enhanced computed tomography scan showed a single endophytic mass of 7.5 cm in diameter. The patient underwent laparoscopic left radical nephrectomy. A final diagnosis of ipsilateral synchronous PRCC and CCRCC was confirmed by pathological examination. There was no recurrence or metastasis after 25 mo follow-up.
CONCLUSION We report a case of ipsilateral synchronous PRCC and CCRCC, and review related literature to estimate the prevalence of similar cases. The above descriptions may be expected to help understand the disease, and improve diagnosis in the future.
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Affiliation(s)
- Jing Yin
- Department of Pathology, The Fifth Central Hospital of Tianjin, Binhai New Area, Tianjin 300450, China
| | - Mo Zheng
- Department of Pathology, The Fifth Central Hospital of Tianjin, Binhai New Area, Tianjin 300450, China
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Unilateral synchronous papillary renal neoplasm with reverse polarity and clear cell renal cell carcinoma: a case report with KRAS and PIK3CA mutations. Diagn Pathol 2020; 15:123. [PMID: 33023600 PMCID: PMC7539524 DOI: 10.1186/s13000-020-01042-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 09/30/2020] [Indexed: 12/20/2022] Open
Abstract
Background The presence of histologically different neoplasms in the same organ is rare in pathologic practice. We report the first case of synchronous clear cell renal cell carcinoma (clear cell RCC) and papillary renal neoplasm with reverse polarity (PRNRP) with comprehensive immunohistochemical and molecular characterization using next-generation sequencing (NGS). Case presentation A 61-year-old man was incidentally found to have a left renal mass on imaging studies performed for workup of left back pain and urine color change for 1 week. A laparoscopic left radical nephrectomy was performed. Gross examination showed lobulated masses measuring 5.6 × 4.0 × 3.3 cm in the upper to mid pole and 1.1 × 1.0 × 1.0 cm in the lower pole. Microscopic findings revealed these to be two different separate masses of clear cell renal cell carcinoma and papillary renal neoplasm with reverse polarity. NGS analyses revealed KRAS gene mutation (c.35G > T/p.G12V in exon 2) in the papillary renal neoplasm with reverse polarity, with PIK3CA gene mutation restricted to the clear cell renal cell carcinoma (c.1624G > A/p.E542K in exon 10). Conclusions We report here an extraordinarily rare case of synchronous renal tumors of papillary renal neoplasm with reverse polarity and clear cell renal cell carcinoma. We identified simultaneous KRAS and PIK3CA mutations in two different renal masses in the same kidney for the first time. New pathologic assessment with comparative molecular analysis of mutational profiles may be helpful for tumor studies.
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Xiang M, Du F, Dai J, Chen L, Geng R, Huang H, Xie B. Exploring serum metabolic markers for the discrimination of ccRCC from renal angiomyolipoma by metabolomics. Biomark Med 2020; 14:675-682. [PMID: 32613842 DOI: 10.2217/bmm-2019-0215] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Aim: The discrimination of renal cell carcinoma from renal angiomyolipoma (RAML) is crucial for the effective treatment of each. Materials & methods: Serum samples were analyzed by nuclear magnetic resonance spectroscopy-based metabolomics and a number of metabolites were further quantified by HPLC-UV. Results: Clear-cell renal carcinoma (ccRCC) was characterized by drastic disruptions in energy, amino acids, creatinine and uric acid metabolic pathways. A logistic model for the differential diagnosis of RAML from ccRCC was established using the combination of serum levels of uric acid, the ratio of uric acid to hypoxanthine and the ratio of hypoxanthine to creatinine as variables with area under the curve of the receiver operating characteristic curve value of 0.907. Conclusion: Alterations in serum purine metabolites may be used as potential metabolic markers for the differential diagnosis of ccRCC and RAML.
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Affiliation(s)
- Mingfeng Xiang
- Department of Urology, The Second Affiliated Hospital of Nanchang University, Nanchang University, Nanchang, PR China
| | - Feng Du
- School of Pharmaceutical Science, Nanchang University, Nanchang, PR China
| | - Jing Dai
- School of Pharmaceutical Science, Nanchang University, Nanchang, PR China
| | - Ling Chen
- School of Pharmaceutical Science, Nanchang University, Nanchang, PR China
| | - Ruijin Geng
- School of Pharmaceutical Science, Nanchang University, Nanchang, PR China
| | - Huiming Huang
- School of Pharmaceutical Science, Nanchang University, Nanchang, PR China
| | - Baogang Xie
- Department of Pharmaceutics, Medical College of Jiaxing University, Jiaxing, PR China.,School of Pharmaceutical Science, Nanchang University, Nanchang, PR China
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Abou Heidar NF, Labban M, Mansour MM, Bannoura S, Degheili JA. Radiologically missed synchronous ipsilateral renal tumours with varying histology. JOURNAL OF CLINICAL UROLOGY 2020. [DOI: 10.1177/2051415819863581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Nassib F Abou Heidar
- Division of Urology, Department of Surgery, American University of Beirut Medical Center, Lebanon
| | - Muhieddine Labban
- Division of Urology, Department of Surgery, American University of Beirut Medical Center, Lebanon
| | - Mazen M Mansour
- Division of Urology, Department of Surgery, American University of Beirut Medical Center, Lebanon
| | - Sami Bannoura
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Lebanon
| | - Jad A Degheili
- Division of Urology, Department of Surgery, American University of Beirut Medical Center, Lebanon
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