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Lan J, Lan D, Yuan W, Ying Q, He J, Gu Y. Radical nephrectomy for a giant chromophobe renal cell carcinoma diagnosed > 17 years previously: a case report and literature review. Front Oncol 2024; 14:1352689. [PMID: 38634044 PMCID: PMC11021568 DOI: 10.3389/fonc.2024.1352689] [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] [Received: 12/08/2023] [Accepted: 03/05/2024] [Indexed: 04/19/2024] Open
Abstract
Early diagnosis of renal cell carcinoma relies on imaging tests such as ultrasound, computed tomography, or magnetic resonance imaging. Since surgery is associated with a favorable prognosis, the standard treatment for clinically limited renal cell carcinoma remains surgical resection. Among asymptomatic patients with localized renal cell carcinoma, a small number refuse surgical treatment and survive. We report a case involving a 59-year-old female who underwent a difficult radical nephrectomy 17 years after being diagnosed with malignant tumors due to primary renal cell carcinoma.
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Affiliation(s)
- Jianhua Lan
- Department of Urology, People’s Hospital of Guang’an City, Guang’an, Sichuan, China
| | - Dong Lan
- Department of Urology, People’s Hospital of Guang’an City, Guang’an, Sichuan, China
| | - Wenqiang Yuan
- Department of Urology, People’s Hospital of Guang’an City, Guang’an, Sichuan, China
| | - Qiao Ying
- Department of Urology, People’s Hospital of Guang’an City, Guang’an, Sichuan, China
| | - Jiahong He
- Department of Cardiac and Vascular Surgery, People’s Hospital of Guang’an City, Guang’an, Sichuan, China
| | - Yonglin Gu
- Department of Cardiology, People’s Hospital of Guang’an City, Guang’an, Sichuan, China
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Charbonneau M, Harper K, Brochu-Gaudreau K, Perreault A, McDonald PP, Ekindi-Ndongo N, Jeldres C, Dubois CM. Establishment of a ccRCC patient-derived chick chorioallantoic membrane model for drug testing. Front Med (Lausanne) 2022; 9:1003914. [PMID: 36275794 PMCID: PMC9582329 DOI: 10.3389/fmed.2022.1003914] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 09/20/2022] [Indexed: 11/13/2022] Open
Abstract
Clear cell renal cell carcinoma (ccRCC) is an aggressive subtype of renal cell carcinoma accounting for the majority of deaths in kidney cancer patients. Advanced ccRCC has a high mortality rate as most patients progress and develop resistance to currently approved targeted therapies, highlighting the ongoing need for adequate drug testing models to develop novel therapies. Current animal models are expensive and time-consuming. In this study, we investigated the use of the chick chorioallantoic membrane (CAM), a rapid and cost-effective model, as a complementary drug testing model for ccRCC. Our results indicated that tumor samples from ccRCC patients can be successfully cultivated on the chick chorioallantoic membrane (CAM) within 7 days while retaining their histopathological characteristics. Furthermore, treatment of ccRCC xenografts with sunitinib, a tyrosine kinase inhibitor used for the treatment of metastatic RCC, allowed us to evaluate differential responses of individual patients. Our results indicate that the CAM model is a complementary in vivo model that allows for rapid and cost-effective evaluation of ccRCC patient response to drug therapy. Therefore, this model has the potential to become a useful platform for preclinical evaluation of new targeted therapies for the treatment of ccRCC.
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Affiliation(s)
- Martine Charbonneau
- Department of Immunology and Cell Biology, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Kelly Harper
- Department of Immunology and Cell Biology, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Karine Brochu-Gaudreau
- Department of Immunology and Cell Biology, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Alexis Perreault
- Department of Immunology and Cell Biology, Université de Sherbrooke, Sherbrooke, QC, Canada
| | | | | | - Claudio Jeldres
- Division of Urology, Department of Surgery, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Claire M. Dubois
- Department of Immunology and Cell Biology, Université de Sherbrooke, Sherbrooke, QC, Canada,*Correspondence: Claire M. Dubois
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Khurram R, Amir T, Chaudhary K, Joshi A, Nayagam K, Tincey S. Metastatic renal cell carcinoma initially presenting as a unilateral breast lump. Radiol Case Rep 2021; 16:945-949. [PMID: 33659034 PMCID: PMC7896124 DOI: 10.1016/j.radcr.2021.02.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 02/01/2021] [Accepted: 02/04/2021] [Indexed: 01/03/2023] Open
Abstract
Breast metastasis from primary renal cell carcinoma is a rare entity and infrequently reported in the literature. We present a case of a 65-year-old lady who presented to breast clinic with a 4-month history of rapidly growing right sided breast lump. She previously had a left mastectomy for breast cancer and a hysterectomy for endometrial cancer. Radiological evaluation with mammography and ultrasound revealed a large heterogeneous right breast lump with prominent vascularity which was biopsied. Histopathological and immunohistochemical features were not supportive of a primary breast carcinoma and favored metastasis from a renal tumor. The patient was unfortunately admitted to hospital due to increasing confusion and neurological symptoms and underwent whole-body cross-sectional CT imaging which demonstrated a giant tumor originating from the right kidney with associated intrathoracic, breast and intracranial metastasis. She was diagnosed with eosinophilic variant metastatic renal cell carcinoma. This case highlights the importance of considering alternative diagnoses to primary breast carcinoma in the context of an initial presentation of a unilateral breast lump.
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Affiliation(s)
- Ruhaid Khurram
- Department of Radiology, Royal Free Hospital, Royal Free London NHS Foundation Trust, Pond St, Hampstead, London, NW3 2QG,Corresponding author.
| | - Taha Amir
- Department of Radiology, Royal Free Hospital, Royal Free London NHS Foundation Trust, Pond St, Hampstead, London, NW3 2QG
| | - Khurram Chaudhary
- Department of Cellular Pathology, Royal Free Hospital, Royal Free London NHS Foundation Trust, Pond St, Hampstead, London, NW3 2QG
| | - Anupam Joshi
- Department of Cellular Pathology, Royal Free Hospital, Royal Free London NHS Foundation Trust, Pond St, Hampstead, London, NW3 2QG
| | - Kesavan Nayagam
- Department of Radiology, Royal Free Hospital, Royal Free London NHS Foundation Trust, Pond St, Hampstead, London, NW3 2QG
| | - Sophia Tincey
- Department of Radiology, Royal Free Hospital, Royal Free London NHS Foundation Trust, Pond St, Hampstead, London, NW3 2QG
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Chen HIH, Lapadat R, Lastra RR, Biernacka A, Reeves W, Mueller J, Pambuccian SE, Barkan GA, Wojcik EM, Antic T. Accuracy of Subclassification and Grading of Renal Tumors on Fine Needle Aspiration Cytology Alone. Acta Cytol 2021; 65:140-149. [PMID: 33535202 DOI: 10.1159/000513065] [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: 10/17/2020] [Accepted: 11/12/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Fine needle aspiration (FNA) of renal masses can distinguish between benign and malignant neoplasms in 73-94% of cases. Previous studies suggested the correct subclassification of renal cell carcinomas (RCCs) by cytomorphology can be achieved in up to 80% of cases. However, as RCCs become increasingly subclassified by molecular signatures, correct subclassification based on cytology alone is increasingly difficult. DESIGN Two FNA passes (2 stained with Diff-Quik® and 2 with the Papanicolaou method) were performed on all fresh nephrectomy specimens for a 1-year period. There were 30 cases in this study, with 29 primary renal tumors and 1 case of metastatic lung adenocarcinoma. Each case was assigned a random number and came with 2 slides (1 from each staining method). Eight cytopathologists were asked to provide a diagnosis and the World Health Organization/International Society of Urological Pathology (WHO/ISUP) grading if applicable. Fleiss' Kappa and Cohen's Kappa equations were used to look at inter-rater variability. RESULTS When compared to the surgical pathology diagnosis, the average percent correct diagnosis for all cytopathologist was 35%. Chromophobe RCCs had the best average percent accuracy at 72% followed by clearcell RCC at 48%. Average accuracy for grading RCCs was 40%. Inter-rater variability among the cytopathologists for all RCC diagnoses was fair with a Fleiss' Kappa coefficient of 0.28. For the WHO/ISUP grade, the weighted coefficient for each pathologist ranged from 0.11 to 0.45, ranging from fair to moderate, respectively. CONCLUSIONS Renal tumors are difficult to classify on cytopathology alone. Core needle biopsy and ancillary studies are necessary if diagnosis will change management.
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Affiliation(s)
- Heather I-Hsuan Chen
- Department of Pathology, The University of Chicago Hospitals, Chicago, Illinois, USA,
| | - Razvan Lapadat
- Department of Pathology, The University of Chicago Hospitals, Chicago, Illinois, USA
| | - Ricardo R Lastra
- Department of Pathology, The University of Chicago Hospitals, Chicago, Illinois, USA
| | - Anna Biernacka
- Department of Pathology, The University of Chicago Hospitals, Chicago, Illinois, USA
| | - Ward Reeves
- Department of Pathology, The University of Chicago Hospitals, Chicago, Illinois, USA
| | - Jeffrey Mueller
- Department of Pathology, The University of Chicago Hospitals, Chicago, Illinois, USA
| | - Stefan E Pambuccian
- Department of Pathology, Loyola University Medical Center, Maywood, Illinois, USA
| | - Güliz A Barkan
- Department of Pathology, Loyola University Medical Center, Maywood, Illinois, USA
| | - Eva M Wojcik
- Department of Pathology, Loyola University Medical Center, Maywood, Illinois, USA
| | - Tatjana Antic
- Department of Pathology, The University of Chicago Hospitals, Chicago, Illinois, USA
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Zhou J, Yang X, Zhou L, Zhang P, Wang C. Combined Immunohistochemistry for the "Three 7" Markers (CK7, CD117, and Claudin-7) Is Useful in the Diagnosis of Chromophobe Renal Cell Carcinoma and for the Exclusion of Mimics: Diagnostic Experience from a Single Institution. DISEASE MARKERS 2019; 2019:4708154. [PMID: 31737127 PMCID: PMC6815563 DOI: 10.1155/2019/4708154] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Accepted: 09/04/2019] [Indexed: 01/07/2023]
Abstract
BACKGROUND There is a morphological overlap among renal epithelial tumors, particularly chromophobe renal cell carcinoma (CHRCC), clear cell renal cell carcinoma (CCRCC), renal oncocytoma (RO), and papillary renal cell carcinoma (PRCC). Discriminating between these tumors is important but sometimes challenging. This study is aimed at evaluating the clinical usefulness of the combined immunochemistry for the "three 7" markers (CK7, CD117, and Claudin-7) to distinguish chromophobe renal cell carcinoma from these mimics. METHODS Immunochemical staining for CK7, CD117, and Claudin-7 was performed in 68 CHRCCs, 199 CCRCCs, 32 ROs, and 30 PRCCs. Fluorescence in situ hybridization (FISH) was performed in some cases to exclude CCRCC and PRCC. The sensitivity (SE) and specificity (SP) for CHRCC as well as the immunoreactivity of each marker and their combinations were statistically evaluated. RESULTS High positive rates for CK7 (94%), CD117 (87%), Claudin-7 (94%), and their combinations (CK7+CD117, 79%; CK7+Claudin-7, 88%; CD117+Claudin-7, 82%; CK7+CD117+Claudin-7, 76%) were observed in CHRCC compared to those in CCRCC, RO, and PRCC, with increasingly higher SP when combinations of the "three 7" markers were applied (CK7, 0.80; CD117, 0.82; Claudin-7, 0.78; CK7+CD117, 0.95; CK7+Claudin-7, 0.97; CD117+Claudin-7, 0.97; CK7+CD117+Claudin-7, 1). CONCLUSION CK7, CD117, and Claudin-7 are frequently expressed in CHRCC with high specificity. We recommend the routine use of these 3 markers as a routine panel when making a differential diagnosis of CHRCC and excluding other mimics.
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Affiliation(s)
- Jun Zhou
- Department of Pathology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xiaoqun Yang
- Department of Pathology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Luting Zhou
- Department of Pathology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Peipei Zhang
- Department of Pathology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Chaofu Wang
- Department of Pathology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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