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Fan H, Guo CF, Luan T, Wang JS. Primary renal well-differentiated neuroendocrine tumor: A case report. Asian J Surg 2024:S1015-9584(24)01614-2. [PMID: 39097444 DOI: 10.1016/j.asjsur.2024.07.241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2024] [Accepted: 07/21/2024] [Indexed: 08/05/2024] Open
Affiliation(s)
- Hong Fan
- Department of Urology, The Second Affiliated Hospital of Kunming Medical University, No. 374 Dian-Mian Avenue, Kunming, Yunnan, 650101, China
| | - Cai-Fang Guo
- Department of Urology, The Second Affiliated Hospital of Kunming Medical University, No. 374 Dian-Mian Avenue, Kunming, Yunnan, 650101, China
| | - Ting Luan
- Department of Urology, The Second Affiliated Hospital of Kunming Medical University, No. 374 Dian-Mian Avenue, Kunming, Yunnan, 650101, China.
| | - Jian-Song Wang
- Department of Urology, The Second Affiliated Hospital of Kunming Medical University, No. 374 Dian-Mian Avenue, Kunming, Yunnan, 650101, China.
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2
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Lin X, Antic T, Hou T, Nezami BG. Cytopathology and clinicopathological correlation of renal neuroendocrine neoplasms. J Am Soc Cytopathol 2024:S2213-2945(24)00058-9. [PMID: 38981825 DOI: 10.1016/j.jasc.2024.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 05/23/2024] [Accepted: 06/05/2024] [Indexed: 07/11/2024]
Abstract
INTRODUCTION There is a lack of documentation regarding cytopathology of renal neuroendocrine neoplasms (NENs) due to their rarity. MATERIALS AND METHODS Five cytology cases were gathered from 3 institutes. RESULTS Cohort consisted of 4 females and 1 male. Fine needle aspiration biopsy and touch preparation slides of core needle biopsy revealed cellular samples, composed of round, plasmacytoid, or columnar cells. Tumor cells were present in nested, acinar, 3D cluster, and individual cell patterns. Tumor cells in 3 cases exhibited uniformly round to oval small nuclei with inconspicuous nucleoli, finely granular chromatin, and smooth nuclear membranes, whereas 2 other cases showed pleomorphic nuclei with conspicuous nucleoli, nuclear molding, and irregular nuclear membranes. Tumor cells displayed pale or granular cytoplasm, with 1 case showing small vacuoles. Examination of cores and cell blocks demonstrated tumor cells in sheets, nests, or acini. All tumor cells were positive for neuroendocrine immunomarkers. Based on mitotic count, Ki-67 index and morphology, 3 tumors were graded as well-differentiated neuroendocrine tumor (WDNET) (1 grade [G] 3, 1 G2, 1 G1) and 2 as large cell neuroendocrine carcinoma. Deletion of 7q, 10q, and 19q was detected in WDNETs. Two patients with large cell neuroendocrine carcinoma and 1 with WDNET G3 underwent chemotherapy due to aggressiveness, whereas nephrectomy was performed for patients with WDNET G1 and 2 without metastasis. CONCLUSIONS Cytopathological characteristics of renal NENs closely resemble those affecting other organs. Despite its rarity, renal NENs should be kept in mind when confronted with morphological resemblances to NENs, to prevent misdiagnosis and inappropriate therapeutic interventions.
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Affiliation(s)
- Xiaoqi Lin
- Department of Pathology, Northwestern University, Chicago, Illinois.
| | - Tatjana Antic
- Department of Pathology, University of Chicago, Chicago, Illinois
| | - Tieying Hou
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Behtash G Nezami
- Department of Pathology, Northwestern University, Chicago, Illinois
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3
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Sunny SS, Hephzibah J, Chacko RT, Kodiatte TA. Therapeutic Response to PRRNT in a Rare Case of Metastatic Renal Neuroendocrine Carcinoma. World J Nucl Med 2024; 23:141-146. [PMID: 38933067 PMCID: PMC11199026 DOI: 10.1055/s-0044-1785461] [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] [Indexed: 06/28/2024] Open
Abstract
Neuroendocrine tumors (NETs) are a rare spectrum of neoplasms that are characterized by neuroendocrine and neural differentiation. The treatment can be challenging in view of the heterogeneity in differentiation and behavior. Primary renal origin NETs are rare and only a few cases have been reported in the literature. There is limited knowledge on their presentation and response to various lines of treatment. We report a case of a patient with a metastatic renal NET from a rare histological subtype of large cell neuroendocrine carcinoma, known to cause aggressive disease with poor prognosis. A multimodality treatment approach was followed. In spite of surgical management and second-line chemotherapy, the disease progressed. The patient subsequently received peptide receptor radionuclide therapy (PRRNT) using lutetium-177 DOTATATE, following which the patient demonstrated a remarkable clinical and radiological response and is stable to date. In a rare tumor with poor prognosis, the relevance of theranostics and the efficacy of targeted therapies like PRRNT are noteworthy.
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Affiliation(s)
- Saumya Sara Sunny
- Department of Nuclear Medicine, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Julie Hephzibah
- Department of Medical Oncology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Raju Titus Chacko
- Department of Medical Oncology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Thomas Alex Kodiatte
- Department of Pathology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
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4
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Omidele OO, Connors C, Wainganker N, Badani K, Sfakianos J, Mehrazin R, Jayaratna I. Prognostic factors and treatment impact on overall survival in patients with renal neuroendocrine tumour. BJUI COMPASS 2024; 5:576-584. [PMID: 38873350 PMCID: PMC11168774 DOI: 10.1002/bco2.341] [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: 11/02/2023] [Revised: 01/24/2024] [Accepted: 01/28/2024] [Indexed: 06/15/2024] Open
Abstract
Background Renal neuroendocrine neoplasms (R-NEN) are exceptionally rare tumours characterized by high mortality rates. Objective The objective of this study is to analyse prognostic factors and treatment impact on overall survival in patients with R-NEN. Design setting and participants We identified all patients with R-NEN in the National Cancer Database (NCDB) from 2004 to 2019 and identified prognostic factors for improved survival. Results and limitations Of 542 R-NEN cases, 166 (31%) were neuroendocrine tumour grade 1 (NET-G1), 14 (3%) were neuroendocrine tumour grade 2 (NET-G2), 169 (31%) were neuroendocrine carcinoma (NEC-NOS), 18 (3%) were large cell neuroendocrine carcinoma (LC-NEC) and 175 (32%) were small cell neuroendocrine carcinoma (SC-NEC). Median overall survival for all patients in the study was 44.88 months (SE, 4.265; 95% CI, 27.57-62.19). Median overall survival was 7.89 months (SE 0.67; 95% CI, 6.58-9.20) for patients without surgical intervention and 136.61 months (SE 16.44; 95% CI, 104.38-168.84, p < 0.001) for patients who underwent surgery. Increased age (HR, 1.05; 95% CI, 1.03-1.06; p < 0.001), T4 stage disease (HR, 3.17; 95% CI, 1.96-5.1; p < 0.001), NEC-NOS histology (HR, 2.82; 95% CI, 1.64-4.86; p < 0.001), LC-NEC histology (HR, 2.73; 95% CI, 1.04-7.17; p = 0.041) and SC-NEC histology (HR, 5.17; 95% CI, 2.95-9.05; p < 0.001) were all positive predictors of worsening overall survival. The main limitation of the study is its retrospective design. Conclusion R-NEN is an aggressive tumour characterized by high mortality rates. Surgery continues to be the mainstay of treatment and has shown to provide a survival benefit for most patients. Patient Summary R-NEN is composed of several tumour histologies that differ based on their aggressiveness with NEC-NOS and SC-NEC being the most lethal. Surgery, predominantly through minimally invasive approaches, is the mainstay of treatment and has a clear survival benefit.
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Affiliation(s)
- Olamide O. Omidele
- Department of UrologyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Christopher Connors
- Department of UrologyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Nikhil Wainganker
- Department of UrologyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Ketan Badani
- Department of UrologyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - John Sfakianos
- Department of UrologyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Reza Mehrazin
- Department of UrologyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Isuru Jayaratna
- Department of UrologyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
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5
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Monroe HL, Patadji Santiago S, Williams HJ, El Naili R. Renal Neuroendocrine Tumor: A Case Report with Evaluation of Grading Criteria and Relationship with Carbonic Anhydrase 9 Immunoreactivity. Int J Surg Pathol 2024; 32:570-577. [PMID: 37461831 DOI: 10.1177/10668969231186931] [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] [Indexed: 12/22/2023]
Abstract
Neuroendocrine tumors (NETs) are only exceptionally primary to the kidney. At present, scant information is known regarding the behavior and prognosis of renal NETs, especially according to the assessment of grading parameters used for NETs originating from other more commonplace sites such as the pancreas and lungs. There are only rare reports of grade assessment in renal NETs, with most of these reports relying upon now antiquated World Health Organization gastroenteropancreatic and lung/thymus criteria. As an additional prognostic factor, positive CA9 staining in NETs may correlate with elevated grade, stage and risk of metastasis while serving as a potential target of chemotherapy and immunotherapy and indicator of Von Hippel-Lindau Syndrome. Rarer still are descriptions of renal NETs presenting with renal cell carcinoma in the ipsilateral or contralateral kidney. Thus, we present a patient with a primary renal NET of the right kidney with regional lymphovascular invasion and distant metastasis with an emphasis on grading criteria concordant with the World Health Organization 2022 gastroenteropancreatic and lung/thymus systems. In addition, we discuss unusual staining for CA9 in the patient's tumor and a concomitant left kidney clear cell renal cell carcinoma that may act as a clinicopathologic mimic of Von Hippel-Lindau Syndrome.
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Affiliation(s)
- Hunter L Monroe
- Department of Pathology, Anatomy and Laboratory Medicine, West Virginia University, Morgantown, WV, USA
| | - Stell Patadji Santiago
- Department of Pathology, Anatomy and Laboratory Medicine, West Virginia University, Morgantown, WV, USA
| | - H James Williams
- Department of Pathology, Anatomy and Laboratory Medicine, West Virginia University, Morgantown, WV, USA
| | - Reima El Naili
- Department of Pathology, Anatomy and Laboratory Medicine, West Virginia University, Morgantown, WV, USA
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6
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Singh S, Kumar N, Anand M, Rizwi K. Renal neuroendocrine tumour with preoperative diagnostic dilemma. BMJ Case Rep 2023; 16:e257896. [PMID: 38087491 PMCID: PMC10728913 DOI: 10.1136/bcr-2023-257896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023] Open
Affiliation(s)
| | | | - Madhur Anand
- King George Medical University, Lucknow, Uttar Pradesh, India
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7
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Kumari N, Verma R, Agrawal V, Singh UP. Primary Renal Well-Differentiated Neuroendocrine Tumors: Analyis of Six Cases from a Tertiary Care Center in North India with Review of Literature. Int J Surg Pathol 2023; 31:982-992. [PMID: 35903907 DOI: 10.1177/10668969221113494] [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] [Indexed: 11/16/2022]
Abstract
Well-differentiated renal neuroendocrine tumors are rare tumors. As their biologic behavior is not fully known, there is a need to know more about these cases. We performed a retrospective chart review of all the cases diagnosed with renal neuroendocrine tumors from January 2016 to December 2020 (five years) in order to understand their clinical features, morphological characteristics and outcome. We included six cases with mean age of 46.2 years (4 males) in our study. All patients underwent radical nephrectomy. Histologically all showed tumor disposed in nests and trabeculae and majority of the tumors belonged to well-differentiated neuroendocrine tumor Grade 1 (WHO criteria of gastoroenteropancreatic neuroendocrine neoplasms). Lymph node metastasis was seen in two cases at the time of clinical presentation. All the tumors were diffusely positive for neuroendocrine tumor markers (synaptophysin, chromogranin, NSE, CD56). Follow-up data was available in all cases with an average follow-up of two years and neither has shown evidence of metastasis or relapse till last follow-up. Role of morphological patterns and immunohistochemical markers is highlighted with the importance of including Ki-67 index in grading them to better understand their outcome.
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Affiliation(s)
- Neha Kumari
- Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, India
| | - Ritu Verma
- Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, India
| | - Vinita Agrawal
- Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, India
| | - Uday Pratap Singh
- Department of Urology and Renal Transplantation, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, India
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8
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Liu C, Qi Y, Zhang Y, Yang X. Primary neuroendocrine neoplasms of the kidney: a case report and literature review. J Int Med Res 2023; 51:3000605231198384. [PMID: 37773688 PMCID: PMC10541770 DOI: 10.1177/03000605231198384] [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: 03/14/2023] [Accepted: 08/14/2023] [Indexed: 10/01/2023] Open
Abstract
Primary kidney neuroendocrine tumors (NETs) are rare renal malignancies. However, detecting and monitoring neuroendocrine neoplasms remains challenging because of their nonspecific nature. We herein present a case involving a 53-year-old woman who experienced episodes of intermittent abdominal pain, dizziness, and nausea for a period of 5 days. Computed tomography urography revealed a small (approximately 19- × 16-mm) nodular shadow in the left kidney. The nodular shadow exhibited slightly lower density than the surrounding tissue as well as enhancement, with a portion protruding into the renal sinus region. Histological and immunohistochemical analyses of the biopsy specimen from the mass indicated a well-differentiated NET. After analysis of this case, we performed a literature review and herein discuss various techniques for imaging and pathological diagnosis of renal NETs. Additionally, we provide insights into the treatment options and prognosis for affected patients. By combining this case study with the existing published literature, we aim to offer a valuable reference for clinicians treatment patients diagnosed with renal NETs.
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Affiliation(s)
- Changxun Liu
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, People’s Republic of China
| | - Yixin Qi
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, People’s Republic of China
| | - Youzhi Zhang
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, People’s Republic of China
| | - Xiaokun Yang
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, People’s Republic of China
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9
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Yang D, Tang W, Wu T, Zhao Z, Liang G. Well‑differentiated neuroendocrine tumor of the right kidney: A case report. Oncol Lett 2023; 25:243. [PMID: 37153061 PMCID: PMC10161357 DOI: 10.3892/ol.2023.13829] [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: 10/27/2022] [Accepted: 03/10/2023] [Indexed: 05/09/2023] Open
Abstract
Neuroendocrine tumors (NETs) are tumors originating from neuroendocrine cells and peptidergic neurons. Primary renal well-differentiated NETs (WDNETs) are rare and only sporadic cases have been reported worldwide. In November 2021, a 45-year-old female patient was admitted to The Affiliated Hospital of Zunyi Medical University (Zunyi, China) with right-sided lumbago. Abdominal computed tomography revealed a 44×34×70-mm mass in the right kidney. Following a complete examination, a laparoscopic partial nephrectomy of the right kidney was performed under general anesthesia. The postoperative pathology indicated a well-differentiated NET of the right kidney. There was no tumor recurrence or metastasis during the 1-year follow-up period. WDNETs are rare, their clinical and imaging findings are not specific, and their diagnosis depends on immunohistochemical analysis. The degree of malignancy is low and the prognosis is positive. Surgical resection is often the first choice, and long-term follow-up is required.
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Affiliation(s)
- Denghao Yang
- Department of Urology, The Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P.R. China
| | - Wen Tang
- Department of Urology, The Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P.R. China
| | - Tao Wu
- Department of Urology, The Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P.R. China
- Correspondence to: Dr Tao Wu, Department of Urology, The Affiliated Hospital of Zunyi Medical University, 145 Dalian Road, Huichuan, Zunyi, Guizhou 563000, P.R. China, E-mail:
| | - Zeju Zhao
- Department of Urology, The Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P.R. China
| | - Guobiao Liang
- Department of Urology, The Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P.R. China
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10
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Le BK, McGarrah P, Paciorek A, Mohamed A, Apolo AB, Chan DL, Reidy-Lagunes D, Hauser H, Rivero JD, Whitman J, Batty K, Zhang L, Raj N, Le T, Bergsland E, Halfdanarson TR. Urinary Neuroendocrine Neoplasms Treated in the "Modern Era": A Multicenter Retrospective Review. Clin Genitourin Cancer 2023; 21:403-414.e5. [PMID: 37031047 PMCID: PMC11296333 DOI: 10.1016/j.clgc.2023.02.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 02/15/2023] [Indexed: 03/19/2023]
Abstract
BACKGROUND Primary urinary neuroendocrine neoplasms (U-NENs) are extremely rare thus optimal treatment is unknown. Grading and treatment are typically extrapolated from other primary sites. Since 2010, the clinical landscape for NENs has changed substantially. We performed a retrospective review of U-NENs to assess treatment patterns and oncologic outcomes of patients treated in the recent era of NEN therapy. PATIENTS AND METHODS A multicenter retrospective review of patients diagnosed after 2005 and alive after 2010. Time to treatment failure (TTF) was used to evaluate progression and toxicity for systemic therapy. Tumors were categorized as having either well-differentiated neuroendocrine tumor (WDNET) or poorly differentiated neuroendocrine carcinoma (PDNEC) histology. RESULTS A total of 134 patients from 6 centers were included in our analysis, including 94 (70%) bladder, 32 (24%) kidney, 2 (1.5%) urethra and 4 other urinary primaries (3.0%). Poorly-differentiated neuroendocrine carcinoma was more common in bladder (92%) than non-bladder tumors (8%). Median Ki-67 available in bladder primary was 90% (n = 24), kidney 10% (n = 23), ureter 95% (n = 1), urethra 54% (n = 2), and others 90% (n = 3). Patients received a median of 2 therapies (range 0-10). Median time to death was not reached in locoregional WDNETs versus 8.2 years (95% CI, 3.5-noncalculable) in metastatic WDNETs (predominantly renal primary). Median time to death was 3.6 years (95% CI, 2.2-9.2) in locoregional PDNECs versus 1 year (95% CI, 0.8-1.3) in metastatic PDNECs (predominantly bladder primary). CONCLUSION This is the most extensive series examining treatment patterns in patients with U-NENs in the recent era of NEN therapy. The apparent inferior survival for bladder NENs is likely due to the preponderance of PDNECs in this group. As predicted, treatments for U-NENs mirrored that of other more common NENs. In our retrospective cohort, we observed that patients with WD-UNETs treated with peptide receptor radionuclide therapy (PRRT) and everolimus suggested potential activity for disease control in WD-UNETs. Prospective studies are needed to assess the activity of new oncology drugs in UNENs.
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Affiliation(s)
- Bryan Khuong Le
- Department of Medicine, University of California, San Francisco, CA
| | | | - Alan Paciorek
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA
| | - Amr Mohamed
- UH Seidman Cancer Center, Case Western Reserve University, Cleveland, OH
| | - Andrea B Apolo
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - David L Chan
- Department of Medical Oncology, Royal North Shore Hospital, St. Leonards, NSW 2065, Sydney, New South Wales, Australia
| | - Diane Reidy-Lagunes
- Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
| | - Haley Hauser
- Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
| | - Jaydira D Rivero
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | | | - Kathleen Batty
- Department of Medical Oncology, Royal North Shore Hospital, St. Leonards, NSW 2065, Sydney, New South Wales, Australia
| | - Li Zhang
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA
| | - Nitya Raj
- Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
| | - Tiffany Le
- Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
| | - Emily Bergsland
- Department of Medicine, University of California, San Francisco, CA.
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11
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Kusuda M, Sawada N, Aikawa J, Sugimura K, Kira S, Mitsui T. Metastatic rectal neuroendocrine tumor to kidney, pancreas, and bone following renal tumor resected with robot-assisted laparoscopic partial nephrectomy. Urol Case Rep 2023; 48:102404. [PMID: 37123513 PMCID: PMC10141494 DOI: 10.1016/j.eucr.2023.102404] [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: 03/09/2023] [Accepted: 04/16/2023] [Indexed: 05/02/2023] Open
Abstract
Neuroendocrine tumor (NET) is a rare tumor commonly found in the gastrointestinal tract and lungs and rarely originates from and metastasizes to the kidney. We report a case of a 66-year-old man with metastatic rectal NET to the kidney, pancreas and bone following the resection of renal tumor with robot-assisted partial nephrectomy (RAPN). A rectal tumor of 10mm in diameter had been endoscopically resected and diagnosed NET with positive surgical margin 9 years before RAPN. Somatostatin receptor (SSR) scintigraphy revealed the other two metastases postoperatively, therefore is an effective tool to detect primary and metastatic sites of NETs.
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Affiliation(s)
- Mayuko Kusuda
- Department of Urology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo, Yamanashi, 409-3898, Japan
| | - Norifumi Sawada
- Department of Urology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo, Yamanashi, 409-3898, Japan
- Corresponding author.
| | - Junki Aikawa
- Department of Urology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo, Yamanashi, 409-3898, Japan
| | - Koki Sugimura
- Urology, Fujiyoshida Municipal Medical Center, Yamanashi, 403-0032, Japan
| | - Satoru Kira
- Department of Urology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo, Yamanashi, 409-3898, Japan
| | - Takahiko Mitsui
- Department of Urology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo, Yamanashi, 409-3898, Japan
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12
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Yin G, Zheng S, He X, Li Y. Primary neuroendocrine tumor of kidney: A case report. Asian J Surg 2023:S1015-9584(23)00257-9. [PMID: 36914466 DOI: 10.1016/j.asjsur.2023.02.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 12/30/2022] [Accepted: 02/16/2023] [Indexed: 03/16/2023] Open
Affiliation(s)
- Guicao Yin
- Department of Urology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, Jiangsu Province, China
| | - Shengqi Zheng
- Department of Urology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, Jiangsu Province, China
| | - Xingjun He
- Department of Urology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, Jiangsu Province, China.
| | - Yifan Li
- Department of Urology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, 225000, Jiangsu Province, China.
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13
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Sharbidre KG, Morani AC, Zahid M, Bhosale P, Lall C, Francis IR, Verma S. Imaging of neuroendocrine neoplasms of the male GU tract. ABDOMINAL RADIOLOGY (NEW YORK) 2022; 47:4042-4057. [PMID: 35412112 DOI: 10.1007/s00261-022-03510-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/24/2022] [Accepted: 03/24/2022] [Indexed: 01/18/2023]
Abstract
Male genitourinary neuroendocrine neoplasms (GU-NENs) are rare, without any definite imaging characteristics. The WHO classified neuroendocrine neoplasms in the 2016 classification of the tumors of the urinary tract and genital organs along with other GU tumors; however, no pathologic grading system is available as published for gastroenteropancreatic neuroendocrine neoplasms. Often a multimodality approach using cross-sectional imaging techniques, such as molecular imaging and histopathology are implemented to arrive at the diagnosis. This article provides a review of the pathology and imaging features of the male GU-NENs.
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Affiliation(s)
- Kedar G Sharbidre
- Department of Radiology, University Of Alabama at Birmingham, Birmingham, USA.
| | - Ajaykumar C Morani
- Department of Radiology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Mohd Zahid
- Department of Radiology, University Of Alabama at Birmingham, Birmingham, USA
| | - Priya Bhosale
- Department of Radiology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Chandana Lall
- Department of Radiology, University of Florida, Gainesville, USA
| | | | - Sadhna Verma
- Department of Radiology, University of Cincinnati, Cincinnati, USA
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14
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Paisey SA, Weerasuriya S, Palmer K, White BE, Srirajaskanthan R, Chandrakumaran K, Ramage JK. Primary renal neuroendocrine neoplasms: A systematic literature review, report of four local cases, and original survival analysis of 63 patients from a national registry 2012-2018. J Neuroendocrinol 2022; 34:e13215. [PMID: 36524462 DOI: 10.1111/jne.13215] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 10/02/2022] [Accepted: 10/13/2022] [Indexed: 11/13/2022]
Abstract
Primary renal neuroendocrine neoplasms (NEN) are rare. We aimed to conduct a systematic review, present local cases, and analyse data from the England's National Cancer Registration and Analysis Service (NCRAS) to provide comprehensive evidence on clinical experience, incidence, and survival to better characterize these tumours. First, a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method; second, a synthesis of local cases; and, finally, a retrospective population-based cohort analysis of renal NEN recorded between 2012 and 2018 on NCRAS were performed. Kaplan-Meier estimator was used to calculate overall survival and Cox proportional hazard regression to identify prognostic factors. Systematic review identified 48 articles and the evidence was summarized and presented. We reported data from four local cases presenting with abdominal and back pain but without carcinoid syndrome. In population-based analysis, we identified 63 cases of renal NEN between 2012 and 2018 from the registry. Age-standardized incidence was 0.09-0.32 per million with a median age of 64 years (interquartile range = 48-72 years). Survival was worse in males and those aged 64 years and over. Five-year survival for renal neuroendocrine tumours (NET) was 69.8% (95% confidence interval = 66.6-72.7) and neuroendocrine carcinomas (NEC) was 38.4% (95% confidence interval = 34.6-42.0). No independent predictive factor was identified in the multivariable analyses. We have given a systematic review of evidence, published local experience, and reported incidence and survival of renal NEN in England for the first time. We have provided clinicians with evidence on diagnosis and proposed a treatment algorithm of theses rare tumours. The incidence and median age of presentation in England is similar to other published series. Renal NET has better survival than renal NEC as expected. A uniform classification system would reduce inconsistencies in reporting and standardize treatment decisions for this neoplasia.
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Affiliation(s)
- Sangeeta A Paisey
- Hampshire Hospitals NHS Foundation Trust, Basingstoke, UK
- King's Health Partners ENETS Centre of Excellence, London, UK
| | | | - Kieran Palmer
- Barts Cancer Centre, St Bartholomew's Hospital, London, UK
| | | | | | | | - John K Ramage
- Hampshire Hospitals NHS Foundation Trust, Basingstoke, UK
- King's Health Partners ENETS Centre of Excellence, London, UK
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15
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Neuroendocrine Neoplasms of the Female Genitourinary Tract: A Comprehensive Overview. Cancers (Basel) 2022; 14:cancers14133218. [PMID: 35804996 PMCID: PMC9264819 DOI: 10.3390/cancers14133218] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 06/25/2022] [Accepted: 06/27/2022] [Indexed: 11/30/2022] Open
Abstract
Simple Summary Primary neuroendocrine neoplasms (NENs) are a rare, heterogeneous group of tumors that include well-differentiated neuroendocrine tumors, poorly differentiated neuroendocrine carcinoma, and paraganglioma. NENs in the urinary tract are observed in <0.05% of individuals, in whom the bladder is the most common site. In this review, we described the epidemiology, pathogenesis, imaging, staging, and management of the genitourinary NENs. Abstract Primary neuroendocrine neoplasms are a rare heterogeneous group of tumors that include well-differentiated neuroendocrine tumors, poorly differentiated neuroendocrine carcinoma, and paraganglioma. An extensive literature search was used to compile the data regarding epidemiology, pathogenesis, imaging features, and management of the urinary system NENs. We also included the updated staging of the NENs at various locations of the urinary system.
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16
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Jiang H, Zhang H. Clinical and Pathological Features of Primary Renal Well-Differentiated Neuroendocrine Tumor. Onco Targets Ther 2022; 15:587-596. [PMID: 35655605 PMCID: PMC9153994 DOI: 10.2147/ott.s364545] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 05/23/2022] [Indexed: 11/25/2022] Open
Abstract
Primary carcinoid tumor of the kidney is an extremely rare well-differentiated neuroendocrine tumor, which is generally a low-grade malignant cancer with a good prognosis. Carcinoid tumors are rarely found in the urinary system. Here, we report a 34-year-old woman with primary renal well-differentiated neuroendocrine tumor who underwent nephron sparing surgery and no evidence of recurrence or distant metastasis was found during routine follow-up. We searched the case of renal carcinoid with the search phrase "carcinoid [title] and kidney [title]" and "carcinoid [title] and renal [title]" using the PubMed and restricted the search to articles published in English since 2013. The clinical manifestations, age, sex, tumor size, location, gross pathology, light microscopy and immunohistochemistry were analyzed. A total of 28 cases of renal carcinoid were retrieved from PubMed. Higher proportion of positive labeling of CgA, Syn, NSE and CD56 are most valuable in the diagnosis of primary renal well-differentiated neuroendocrine tumor. At present, radical nephrectomy remains the gold standard in the curative-intent therapy for well-differentiated neuroendocrine carcinoma of kidney, in metastatic renal carcinoid, long-term use of octreotide may be an effective adjuvant therapy.
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Affiliation(s)
- Hua Jiang
- Department of Urology, The Fifth Affiliated Hospital of Zunyi Medical University (Zhuhai Sixth People’s Hospital), Zhuhai, People’s Republic of China
| | - He Zhang
- Department of Urology, The Fifth Affiliated Hospital of Zunyi Medical University (Zhuhai Sixth People’s Hospital), Zhuhai, People’s Republic of China
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17
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Deacon MJ, Harvey H, Shah C, Khan A. A Rare Case of a Large Primary Renal Neuroendocrine Tumour: A Case Report and Brief Review of Literature. Cureus 2021; 13:e19743. [PMID: 34812336 PMCID: PMC8604431 DOI: 10.7759/cureus.19743] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2021] [Indexed: 11/05/2022] Open
Abstract
Primary renal neuroendocrine tumours are very rare clinical entities, and as such, relatively little is known about their clinical progression. Here, we outline the case of a young female patient presenting with abdominal pain and a large 14 cm right renal mass. Initial radiological studies demonstrated localised disease, but during surgical resection, widespread liver metastasis was identified. Histological analysis revealed a grade 2, well-differentiated neuroendocrine tumour pT3a. Whilst surgical resection remains the gold standard for localised disease, further work is required to understand the pathogenesis, prognostic indicators and treatment following metastatic spread. The poor prognosis seen in primary renal neuroendocrine neoplasia highlights the importance of further directed research in this area.
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Affiliation(s)
| | - Hannah Harvey
- Urology Department, King's College Hospital, London, GBR
| | - Chirag Shah
- Pathology Department, King's College Hospital, London, GBR
| | - Azhar Khan
- Urology Department, King's College Hospital, London, GBR
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18
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Navarro-Ballester A, Rodenas-Hernández JM, de Lázaro-de Molina S, Muñoz-Vicente E. Primary neuroendocrine tumour of the kidney in an asymptomatic patient involving a multidisciplinary approach. BMJ Case Rep 2021; 14:e245658. [PMID: 34753729 PMCID: PMC8578955 DOI: 10.1136/bcr-2021-245658] [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] [Accepted: 10/02/2021] [Indexed: 11/04/2022] Open
Abstract
Primary neuroendocrine tumours of the kidney are rare, and their pathophysiology is uncertain; since their discovery in 1966, they have been described only a few times in the literature. We present a case of a well-differentiated neuroendocrine tumour of the kidney in an asymptomatic patient, which required a multidisciplinary approach by the hospital's team, including precise surgical treatment and an effective radiopathological diagnosis. The patient underwent right radical nephrectomy. During follow-up, he remained asymptomatic, and no metastases or complications were identified.
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Affiliation(s)
- Antonio Navarro-Ballester
- Department of Radiology, Hospital General Universitari de Castelló, Castellon de la Plana, Comunidad Valenciana, Spain
| | - Jose Manuel Rodenas-Hernández
- Department of Radiology, Hospital General Universitari de Castelló, Castellon de la Plana, Comunidad Valenciana, Spain
| | - Susana de Lázaro-de Molina
- Department of Radiology, Hospital General Universitari de Castelló, Castellon de la Plana, Comunidad Valenciana, Spain
| | - Elia Muñoz-Vicente
- Department of Pathology, Hospital General Universitari de Castelló, Castellon de la Plana, Comunidad Valenciana, Spain
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19
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Single institutional experience on primary neuroendocrine neoplasms of the kidney: a rare distinct entity. Hum Pathol 2021; 114:36-43. [PMID: 33891968 DOI: 10.1016/j.humpath.2021.04.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 04/01/2021] [Accepted: 04/06/2021] [Indexed: 01/12/2023]
Abstract
Primary pure renal neuroendocrine neoplasms (R-NENs) are a distinct and rare entity. Not much is known about the histopathology and biologic behavior of these tumors. We attempted to review the clinicopathologic aspects of these neoplasms encountered at our institution. We performed a retrospective chart review to identify primary pure (not admixed with any other tumor component) R-NENs from institutional Cancer Registry database. Pathologic review of the diagnostic archival slides was done for detailed assessment of the histologic features. R-NENs were classified according to the current WHO system for gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs). Eight pure R-NEN cases were identified, all unifocal, and most (6/8) involved the right kidney. Three patients had poorly differentiated neuroendocrine carcinoma (NEC), and five had well-differentiated neuroendocrine tumor (NET). All tumors were located near the renal hilum, stained diffusely with synaptophysin, variably with chromogranin, and were negative for renal site-specific marker PAX8 or for markers of renal cell carcinoma. We identified two distinct patterns of growth: one of sheets with interspersed rosettes and the other of large nests with low proliferative crowded centers and peripheral cells with higher proliferation and prominent palisading. Based on Ki-67 proliferative index, the tumors were classifiable into WHO grade 1 or grade 2 (based on GEP-NEN). All three NECs characteristically showed cytologic features intermediate between classic large and small cell type. This is the first comprehensive clinicopathologic study involving the rare group of R-NEN. Classifying and grading them according to the GEP-NEN system is of prognostic significance.
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20
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Kelly EF, Connelly ZM, Noonan MJ, Gu X, Khater N. Primary Renal Carcinoid: Two Rare Cases at a Single Center. Cureus 2021; 13:e13907. [PMID: 33880263 PMCID: PMC8046686 DOI: 10.7759/cureus.13907] [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] [Indexed: 01/01/2023] Open
Abstract
Renal carcinoid tumors are exceedingly rare. These neuroendocrine masses are most frequently found in the gastrointestinal and respiratory tracts. A renal carcinoid tumor has only been documented in around 100 cases. In this article, we report two additional cases in female patients ages 53 and 63. Both tumors were found incidentally on computed tomography scans. Both women underwent radical nephrectomies. Neither has shown evidence of metastasis nor relapse to date; however, the 63-year-old woman was lost to follow-up. In conclusion, upon discovery of the asymptomatic renal mass, renal carcinoid should be a consideration in the differentiation, and if suspected, may be treated with radical nephrectomy as was done in our hospital.
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Affiliation(s)
- Emily F Kelly
- Urology, Louisiana State University Health Shreveport, Shreveport, USA
| | | | | | - Xin Gu
- Pathology, Louisiana State University Health Shreveport, Shreveport, USA
| | - Nazih Khater
- Urology, Louisiana State University Health Shreveport, Shreveport, USA
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21
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Song S, Liang X, Jiang B, Hou S. Primary renal large cell neuroendocrine carcinoma with horseshoe kidney: A case report. Asian J Surg 2021; 44:702-703. [PMID: 33568338 DOI: 10.1016/j.asjsur.2021.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 01/25/2021] [Indexed: 10/22/2022] Open
Affiliation(s)
- Shizhang Song
- Department of Urology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Xin Liang
- Department of Urology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Bo Jiang
- Department of Urology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China.
| | - Sichuan Hou
- Department of Urology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China.
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22
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Jhang S, Chiu AW. An infertile female delivered a baby after removal of primary renal carcinoid tumor. Open Med (Wars) 2021; 16:146-148. [PMID: 33542957 PMCID: PMC7819483 DOI: 10.1515/med-2020-0408] [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: 05/28/2019] [Revised: 12/08/2019] [Accepted: 12/28/2019] [Indexed: 11/15/2022] Open
Abstract
Primary renal carcinoid tumors are exceedingly rare. We report a 37-year-old woman with primary infertility, who was found to have a primary renal carcinoid tumor. She became pregnant and gave birth to a baby after removal of the tumor. This is the first case in the English literature of primary renal carcinoid tumor related with primary infertility.
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Affiliation(s)
- Syu Jhang
- Department of Urology, MacKay Memorial Hospital, No. 92, Sec. 2, Zhongshan N. Rd., 10449, Taipei, Taiwan.,School of Medicine, Mackay Medical College, No. 92, Sec. 2, Zhongshan N. Rd., 10449, Sanzhi, Taiwan
| | - Allen W Chiu
- Department of Urology, MacKay Memorial Hospital, No. 92, Sec. 2, Zhongshan N. Rd., 10449, Taipei, Taiwan.,School of Medicine, Mackay Medical College, No. 92, Sec. 2, Zhongshan N. Rd., 10449, Sanzhi, Taiwan.,Division of Urology, Department of Surgery, Taipei City Hospital, No. 92, Sec. 2, Zhongshan N. Rd., 10449, Taipei, Taiwan.,School of Medicine, National Yang-Ming University, No. 92, Sec. 2, Zhongshan N. Rd., 10449, Taipei, Taiwan
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23
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Rodriguez Pena MDC, Salles DC, Epstein JI, Canete-Portillo S, Tregnago AC, Ramirez J, Meliti A, Netto GJ. Well-differentiated neuroendocrine tumors of the lower urinary tract: biologic behavior of a rare entity. Hum Pathol 2020; 109:53-58. [PMID: 33301750 DOI: 10.1016/j.humpath.2020.11.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 11/30/2020] [Indexed: 11/25/2022]
Abstract
The spectrum of neuroendocrine (NE) tumors in the genitourinary tract ranges from the aggressive large and small cell carcinomas to the often benign paraganglioma and well-differentiated neuroendocrine tumor (WD-NET). At least 15 pure lower urinary tract (LUT) WD-NETs have been described. Owing to the rarity of WD-NET in the LUT and the limited number of reported cases, a better definition of their biologic long-term behavior is warranted. Herein, we aim to describe 10 new cases of WD-NET arising in the LUT and expand on follow-up findings. Ten consultation cases were identified and included 6 men and 4 women who ranged from 45 to 73 years of age. Seven cases arose in the bladder with one located in the bladder neck, 1 arose in the prostatic urethra, 1 arose in the female urethra, and 1 arose in the left ureteral orifice. All lesions were confined to the lamina propria, and tumor architecture was pseudoglandular in all cases. Associated cystitis cystica et glandularis was identified in 5 cases; urothelial papilloma and florid von Brunn's nests were found in 2 additional cases. Immunohistochemical staining for synaptophysin and chromogranin was diffusely positive in 9 cases and focal in 1 case, and the Ki-67 proliferation index was 5% or less in all tumors. Follow-up ranged from 37 to 137 months (mean = 82; median = 77), and there was no evidence of residual disease or recurrence in any of the 10 patients during the follow-up period.
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Affiliation(s)
- Maria Del Carmen Rodriguez Pena
- Department of Pathology, Johns Hopkins Hospital, Baltimore, MD, 21287, USA; Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, 35233, USA
| | - Daniela C Salles
- Department of Pathology, Johns Hopkins Hospital, Baltimore, MD, 21287, USA
| | - Jonathan I Epstein
- Department of Pathology, Johns Hopkins Hospital, Baltimore, MD, 21287, USA
| | - Sofia Canete-Portillo
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, 35233, USA
| | - Aline C Tregnago
- Department of Pathology, Johns Hopkins Hospital, Baltimore, MD, 21287, USA
| | - July Ramirez
- Department of Pathology, Johns Hopkins Hospital, Baltimore, MD, 21287, USA
| | - Abdelrazak Meliti
- Department of Pathology, Johns Hopkins Hospital, Baltimore, MD, 21287, USA
| | - George J Netto
- Department of Pathology, Johns Hopkins Hospital, Baltimore, MD, 21287, USA; Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, 35233, USA.
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24
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Dempsey PJ, O'Connell MJ, Bolster F. Solitary late metastasis of primary renal cell carcinoid tumor to the extraocular muscles imaged with indium-111 octreotide. World J Nucl Med 2020; 20:99-101. [PMID: 33850497 PMCID: PMC8034783 DOI: 10.4103/wjnm.wjnm_28_20] [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: 03/17/2020] [Revised: 04/07/2020] [Accepted: 05/01/2020] [Indexed: 11/10/2022] Open
Abstract
A 75-year-old male presented with right eye pain and proptosis. His history was significant for renal cell carcinoma treated with left nephrectomy 2 years previously. Computed tomography (CT) imaging demonstrated a 1.6-cm enhancing lesion in the right retrobulbar space. Surgical biopsy revealed a low-grade metastatic carcinoid tumor. At retrospective review, the primary renal lesion from 2 years prior was rediagnosed as consistent with a renal carcinoid tumor. Indium-111 octreotide single photon emission CT/CT imaging demonstrated a solitary metastasis within the right extraocular muscles. The patient subsequently developed additional metastases within the remaining right kidney and lung.
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Affiliation(s)
- Philip Jude Dempsey
- Department of Radiology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Martin J O'Connell
- Department of Radiology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Ferdia Bolster
- Department of Radiology, Mater Misericordiae University Hospital, Dublin, Ireland
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25
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Jabaji R, Kern T, Shen D, Chu W, Merchant M. Primary Renal Carcinoid Tumor: Report of Two Cases. Perm J 2020; 24:19.147. [PMID: 32240087 DOI: 10.7812/tpp/19.147] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Primary renal carcinoid tumors are a rare subset of neuroendocrine tumors arising in the kidneys. Although carcinoid syndrome has occasionally been described, most patients are asymptomatic at presentation. CASE PRESENTATIONS We present 2 cases of primary renal carcinoid tumor and describe the workup, immunohistochemical analysis, treatment, and surveillance of each female patient. The first patient was found to have a renal mass on imaging during a workup of chronic abdominal pain and subsequently underwent a robotic radical nephrectomy. The second patient was found to have an incidental renal mass on imaging and subsequently underwent renal biopsy, followed by robot-assisted laparoscopic partial nephrectomy. In both cases, a gallium dotatate Ga 68-enhanced positron emission tomography/computed tomography scan was used to further assess disease burden. DISCUSSION This report describes 2 cases of primary renal carcinoid tumor with unique presentations and management in our regional health care system. Because primary renal carcinoid tumors are quite uncommon, there are no clear established guidelines on preoperative imaging or posttreatment surveillance in patients with these tumors. There remains a large amount of variability in the diagnosis, workup, immunohistochemical analysis, treatment, and surveillance of patients with primary renal carcinoid tumors. As we learn more about this disease, we hope to optimize patient outcomes and standardize pretreatment workup and posttreatment surveillance.
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Affiliation(s)
- Ramzi Jabaji
- Department of Urology, Los Angeles Medical Center, CA
| | - Tyler Kern
- Department of Urology, Los Angeles Medical Center, CA
| | - Dejun Shen
- Department of Pathology, Downey Medical Center, CA
| | - William Chu
- Department of Urology, Downey Medical Center, CA
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26
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Bhaskar S, Rastogi K, Gupta S, Jindal A. Primary Neuroendocrine Carcinoma of Kidney: Report of a Rare Case. Indian J Med Paediatr Oncol 2020. [DOI: 10.4103/ijmpo.ijmpo_114_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AbstractPrimary neuroendocrine tumor (NET) of kidney is extremely rare, with <100 cases reported so far. The aim of the present case study is to discuss the clinical and pathological findings of renal NET and review of the available literature. We herein report the case of a 42-year-old female patient, who presented with pain abdomen and hematuria. Immunohistochemistry of her nephrectomy specimen was positive for chromogranin A and CD56 and negative for uroplakin II, P40, and CD10. KI index was 60%. Due to rarity of the tumor, there are no established guidelines available for its treatment. She was treated with combination chemotherapy of cisplatin and etoposide.
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Affiliation(s)
- Sandeep Bhaskar
- Department of Radiotherapy, SMS Medical College and Attached Group of Hospitals, Jaipur, Rajasthan, India
| | - Kartick Rastogi
- Department of Radiotherapy, SMS Medical College and Attached Group of Hospitals, Jaipur, Rajasthan, India
| | - Shivani Gupta
- Department of Radiotherapy, SMS Medical College and Attached Group of Hospitals, Jaipur, Rajasthan, India
| | - Arpita Jindal
- Department of Pathology, SMS Medical College and Attached Group of Hospitals, Jaipur, Rajasthan, India
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27
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Nguyen AH, O’Leary MP, De Andrade JP, Ituarte PHG, Kessler J, Li D, Singh G, Chang S. Natural History of Renal Neuroendocrine Neoplasms: A NET by Any Other Name? Front Endocrinol (Lausanne) 2020; 11:624251. [PMID: 33613455 PMCID: PMC7894255 DOI: 10.3389/fendo.2020.624251] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 12/15/2020] [Indexed: 11/13/2022] Open
Abstract
Renal neuroendocrine neoplasms are rare, with descriptions of cases limited to individual reports and small series. The natural history of this group of neuroendocrine neoplasms is poorly understood. In this study, we queried the Surveillance, Epidemiology and End Results (SEER) database over a four-decade period where we identified 166 cases of primary renal neuroendocrine neoplasms. We observed a 5-year overall survival of 50%. On multivariate analysis, survival was influenced by stage, histology, and if surgery was performed. We observed that patients managed by operative management had a greater frequency of localized or regional stage disease as well as a greater frequency of neuroendocrine tumor, grade 1 histology; whereas those managed non-operatively tended to have distant disease and histologies of neuroendocrine carcinoma, NOS and small cell neuroendocrine carcinoma. This is the largest description of patients with renal neuroendocrine neoplasms. Increased survival was observed in patients with earlier stage and favorable histologies.
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Affiliation(s)
| | | | | | | | - Jonathan Kessler
- Department of Diagnostic Radiology, Division of Interventional Radiology, City of Hope, Duarte, CA, United States
| | - Daneng Li
- Department of Medical Oncology, City of Hope, Duarte, CA, United States
| | - Gagandeep Singh
- Department of Surgery, City of Hope, Duarte, CA, United States
| | - Sue Chang
- Department of Pathology, City of Hope, Duarte, CA, United States
- *Correspondence: Sue Chang,
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28
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Neyaz A, Neyaz Z, Husain N, Gupta V. Primary Renal Neuroendocrine Tumour Presenting as an Enormous Cystic Lesion. Turk Patoloji Derg 2020; 36:90-92. [PMID: 29235611 PMCID: PMC10512688 DOI: 10.5146/tjpath.2017.01418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Azfar Neyaz
- Dr. Ram Manohar Lohia Institute of Medical Sciences, Department of Pathology, Lucknow, India
| | - Zafar Neyaz
- Sanjay Gandhi Postgraduate Institute of Medical Sciences, Department of Radiodiagnosis, Lucknow, India
| | - Nuzhat Husain
- Dr. Ram Manohar Lohia Institute of Medical Sciences, Department of Pathology, Lucknow, India
| | - Vani Gupta
- Dr. Ram Manohar Lohia Institute of Medical Sciences, Department of Pathology, Lucknow, India
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29
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Srivatsav A, Balasubramanian A, Scovell J, Mayer W. Robotic-assisted laparoscopic resection of a primary renal neuroendocrine carcinoma. BMJ Case Rep 2019; 12:12/12/e232148. [PMID: 31822533 DOI: 10.1136/bcr-2019-232148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Primary renal neuroendocrine carcinomas (RNC) are extremely rare urological neoplasms, with fewer than 100 cases reported in the literature. There are no established protocols concerning diagnosis and treatment, and there is no definitive data on prognosis. Here, we report the findings of a 54-year-old woman who presented with intermittent back pain due to a large mass, which was initially suspected to be a renal cell or upper tract urothelial carcinoma. The patient underwent robotic-assisted laparoscopic nephrectomy and lymph node dissection without complications. Pathology revealed an RNC with local metastases to para-aortic lymph nodes without evidence of another primary origin. Subsequent surveillance showed no evidence of disease until 48-month follow-up imaging revealed a liver lesion suspicious for possible metastatic cancer. This report represents the second documented usage of robot-assisted laparoscopic nephrectomy for RNC and the longest follow-up in the literature. We review the diagnosis, treatment and follow-up of patients with RNC.
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Affiliation(s)
- Ashwin Srivatsav
- Department of Urology, Baylor College of Medicine, Houston, Texas, USA
| | | | - Jason Scovell
- Department of Urology, Baylor College of Medicine, Houston, Texas, USA
| | - Wesley Mayer
- Department of Urology, Baylor College of Medicine, Houston, Texas, USA
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30
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Salehipour M, Mostaghni AA, Geramizadeh B, Makarem A, Rezvani A. Constipation, the sole presentation of primary renal carcinoid tumor: A case report. Rare Tumors 2019; 11:2036361319878915. [PMID: 31692698 PMCID: PMC6811761 DOI: 10.1177/2036361319878915] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 08/28/2019] [Indexed: 11/15/2022] Open
Abstract
Primary renal carcinoid tumors are quite rare. The pathogenesis of these tumors is unknown due to lack of enterochromaffin cells in the kidney. Because of nonspecific clinical manifestations and radiologic features, they are commonly misdiagnosed. Hence, Primary renal carcinoid tumors should be considered in differential diagnosis of any renal mass. In the present case, a 26-year-old woman was presented with a renal mass and constipation. After partial nephrectomy, diagnosis of carcinoid tumor was confirmed.
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Affiliation(s)
- Mehdi Salehipour
- Department of Urology, Shiraz University
of Medical Sciences, Shiraz, Iran
| | - Amir Ahmad Mostaghni
- Department of Internal Medicine, Shiraz
University of Medical Sciences, Shiraz, Iran
| | - Bita Geramizadeh
- Department of Pathology, Transplant
Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Makarem
- Department of Urology, Shiraz University
of Medical Sciences, Shiraz, Iran
| | - Alireza Rezvani
- Department of Internal Medicine, Shiraz
University of Medical Sciences, Shiraz, Iran
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Pivovarcikova K, Agaimy A, Martinek P, Alaghehbandan R, Perez‐Montiel D, Alvarado‐Cabrero I, Rogala J, Kuroda N, Rychly B, Gasparov S, Michalova K, Michal M, Hora M, Pitra T, Tuckova I, Laciok S, Mareckova J, Hes O. Primary renal well‐differentiated neuroendocrine tumour (carcinoid): next‐generation sequencing study of 11 cases. Histopathology 2019; 75:104-117. [DOI: 10.1111/his.13856] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 03/06/2019] [Indexed: 12/16/2022]
Affiliation(s)
- Kristyna Pivovarcikova
- Department of Pathology, Faculty of Medicine in Plzen Charles University in Prague Pilsen Czech Republic
| | - Abbas Agaimy
- Department of Pathology University of Erlangen Erlangen Germany
| | - Petr Martinek
- Department of Pathology, Faculty of Medicine in Plzen Charles University in Prague Pilsen Czech Republic
| | - Reza Alaghehbandan
- Department of Pathology, Faculty of Medicine University of British Columbia, Royal Columbian Hospital Vancouver British Columbia Canada
| | | | | | - Joanna Rogala
- Department of Pathology Wojewódzki Szpital Specjalistyczny Wroclaw Poland
| | - Naoto Kuroda
- Department of Diagnostic Pathology Kochi Red Cross Hospital Kochi Japan
| | - Boris Rychly
- Department of Pathology Cytopathos Bratislava Slovakia
| | | | - Kvetoslava Michalova
- Department of Pathology, Faculty of Medicine in Plzen Charles University in Prague Pilsen Czech Republic
| | - Michal Michal
- Department of Pathology, Faculty of Medicine in Plzen Charles University in Prague Pilsen Czech Republic
| | - Milan Hora
- Department of Urology, Faculty of Medicine in Plzeň Charles University in Prague Pilsen Czech Republic
| | - Tomas Pitra
- Department of Urology, Faculty of Medicine in Plzeň Charles University in Prague Pilsen Czech Republic
| | - Inna Tuckova
- Department of Pathology Central Military Hospital Prague Prague Czech Republic
| | - Simon Laciok
- Department of Pathology Regional Hospital Havirov Havirov Czech Republic
| | - Jana Mareckova
- Department of Pathology, Faculty of Medicine in Plzen Charles University in Prague Pilsen Czech Republic
| | - Ondrej Hes
- Department of Pathology, Faculty of Medicine in Plzen Charles University in Prague Pilsen Czech Republic
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32
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Kato R, Fukushima H, Kobayashi M, Kawano K, Morimoto S. A young female case of primary renal carcinoid tumor mimicking fat-poor angiomyolipoma. Int Cancer Conf J 2019; 7:156-158. [PMID: 31149537 DOI: 10.1007/s13691-018-0341-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 08/16/2018] [Indexed: 11/25/2022] Open
Abstract
Renal mass biopsy is useful for the pathological diagnosis of a small renal mass difficult to distinguish fat-poor angiomyolipoma from renal cell carcinoma radiologically. Here, we report a young female case of a small renal mass suspected as fat-poor angiomyolipoma in imaging studies. The patient received a renal mass biopsy to obtain the correct pathological information. Unexpectedly, the pathological diagnosis was neuroendocrine tumor. She, finally, underwent a right radical nephrectomy as a curative treatment. This case indicates that the radiological findings of primary renal carcinoid tumor can be similar to those of fat-poor angiomyolipoma.
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Affiliation(s)
- Rie Kato
- Department of Urology, Tsuchiura Kyodo General Hospital, 4-1-1 Ootsuno, Tsuchiura, Ibaraki 300-0028 Japan
| | - Hiroshi Fukushima
- Department of Urology, Tsuchiura Kyodo General Hospital, 4-1-1 Ootsuno, Tsuchiura, Ibaraki 300-0028 Japan
| | - Masaki Kobayashi
- Department of Urology, Tsuchiura Kyodo General Hospital, 4-1-1 Ootsuno, Tsuchiura, Ibaraki 300-0028 Japan
| | - Keizo Kawano
- Department of Urology, Tsuchiura Kyodo General Hospital, 4-1-1 Ootsuno, Tsuchiura, Ibaraki 300-0028 Japan
| | - Shinji Morimoto
- Department of Urology, Tsuchiura Kyodo General Hospital, 4-1-1 Ootsuno, Tsuchiura, Ibaraki 300-0028 Japan
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33
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WITHDRAWN: Double primary carcinoid tumors of the kidney. Asian J Urol 2019. [DOI: 10.1016/j.ajur.2019.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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34
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Kim B, Kim HS, Moon KC. Primary renal well-differentiated neuroendocrine tumors: report of six cases with an emphasis on the Ki-67 index and mitosis. Diagn Pathol 2019; 14:12. [PMID: 30732641 PMCID: PMC6367815 DOI: 10.1186/s13000-019-0791-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 02/01/2019] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Primary renal well-differentiated neuroendocrine tumors (WDNETs) also called carcinoid and atypical carcinoid are extremely rare, and little is known about parameters that may predict prognosis at diagnosis. METHODS Six cases of primary renal WDNET were collected. After reviewing slides stained with hematoxylin and eosin, proportions of each growth pattern were determined. Synaptophysin, chromogranin, CD56, and Ki-67 immunostaining and Ki-67 morphometric analysis were performed. RESULTS Patients included three female and three males, mean age was 53.3 years. The mean tumor size was 4.5 cm, three cases were greater than 5 cm. At the time of initial surgery, lymph node and/or distant metastasis was confirmed in two cases. In a third case, no metastasis was initially found, but lymph node metastasis was identified during follow-up. The remaining three cases did not exhibit metastasis. Histopathologically, the renal WDNETs were primarily composed of ribbon-like and sheet-like growth patterns. Most of the tumors were diffusely positive for neuroendocrine markers. Mitotic count was high (≥2/10HPF) in cases with lymph node or distant metastasis but was low (< 2/10HPF) in non-metastatic cases. Furthermore, the Ki-67 index was also higher (≥3%) in the cases with metastases than in cases without metastasis. CONCLUSION Three out of the six primary renal WDNETs demonstrated aggressive behavior and exhibited increased mitotic counts and Ki-67 indices. These results suggest that mitosis and the Ki-67 index could be used as prognostic indicators for renal WDNET.
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Affiliation(s)
- Bohyun Kim
- Department of Pathology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Han-Seong Kim
- Department of Pathology, Inje University College of Medicine, Goyang, Republic of Korea
| | - Kyung Chul Moon
- Department of Pathology, Seoul National University College of Medicine, Seoul, Republic of Korea
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35
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Five New Cases of Primary Renal Carcinoid Tumor: Case Reports and Literature Review. Pathol Oncol Res 2018; 26:341-346. [DOI: 10.1007/s12253-018-0481-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 10/04/2018] [Indexed: 12/29/2022]
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Abstract
Neuroendocrine neoplasms (NEN) are rare and heterogeneous. Therefore, they often remain unrecognized for many years, causing significant disease burden. We here report on four unusual NEN presentations including a metastatic NEN of the kidney, hypoglycemia caused by an insulin-like growth factor-2-oma (previously called non-islet-cell tumor hypoglycemia), multifocal pheochromocytoma in von Hippel Lindau syndrome, and ileal NEN metastatic to the heart. One could say that each one of these tumors were "black swans" and learning about them will increase further awareness of the spectrum of NEN.
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Affiliation(s)
- Christian A Koch
- Medicover GmbH, Berlin / Hannover, Germany.
- Carl von Ossietzky University of Oldenburg, Oldenburg, Germany.
- Technical University of Dresden, Dresden, Germany.
- University of Louisville, Louisville, KY, USA.
| | - S Petersenn
- ENDOC Center for Endocrine Tumors, Hamburg, Germany
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37
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Akca A, Otto T, Hinsch N, Lammers BJ, Starke AAR, Goretzki PE. [Rare renal tumors]. Urologe A 2017; 57:193-197. [PMID: 29242949 DOI: 10.1007/s00120-017-0553-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- A Akca
- Klinik für Allgemein‑, Visceral‑, Thorax‑, Gefäß- und Endokrine Chirurgie, Lukaskrankenhaus Neuss, Preussenstr. 84, 41464, Neuss, Deutschland. .,Insulinom und GEP-NET-Zentrum Neuss, Neuss, Deutschland.
| | - T Otto
- Klinik für Urologie, Lukaskrankenhaus Neuss, Neuss, Deutschland
| | - N Hinsch
- Institut für Pathologie, Lukaskrankenhaus Neuss, Neuss, Deutschland
| | - B J Lammers
- Klinik für Allgemein‑, Visceral‑, Thorax‑, Gefäß- und Endokrine Chirurgie, Lukaskrankenhaus Neuss, Preussenstr. 84, 41464, Neuss, Deutschland.,Insulinom und GEP-NET-Zentrum Neuss, Neuss, Deutschland
| | - A A R Starke
- Insulinom und GEP-NET-Zentrum Neuss, Neuss, Deutschland
| | - P E Goretzki
- Klinik für Allgemein‑, Visceral‑, Thorax‑, Gefäß- und Endokrine Chirurgie, Lukaskrankenhaus Neuss, Preussenstr. 84, 41464, Neuss, Deutschland.,Insulinom und GEP-NET-Zentrum Neuss, Neuss, Deutschland
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38
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Gu X, Cheng M, Herrera GA. Kidney carcinoid tumor: Histological, immunohistochemical and ultrastructural features. Ultrastruct Pathol 2017; 42:18-22. [DOI: 10.1080/01913123.2017.1388321] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Xin Gu
- Department of Pathology, Louisianan State University Health Science Center-Shreveport, Shreveport, LA, USA
| | - Minyu Cheng
- Department of Pathology, Louisianan State University Health Science Center-Shreveport, Shreveport, LA, USA
| | - Guillermo A Herrera
- Department of Pathology, Louisianan State University Health Science Center-Shreveport, Shreveport, LA, USA
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39
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Primary Renal Carcinoid with Bilateral Multiple Clear Cell Papillary Renal Cell Carcinomas. Case Rep Pathol 2017; 2017:9672368. [PMID: 28620558 PMCID: PMC5460381 DOI: 10.1155/2017/9672368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Accepted: 05/02/2017] [Indexed: 11/17/2022] Open
Abstract
Clear cell papillary renal cell carcinoma (CCPRCC) is a newly recognized entity in the 2016 WHO classification and usually presents as a small, circumscribed, solitary mass of indolent nature. CCPRCCs could seldom occur in conjunction with other synchronous or metachronous kidney tumors and even less frequently as bilateral masses. To our knowledge, multiple bilateral CCPRCCs have never been described with the existence of a synchronous well-differentiated neuroendocrine tumor of the kidney and hence reported here as a unique case. This case report highlights the importance in considering this entity and its unusual presentation in the differential diagnosis as a possible mimicker of Von Hippel-Lindau syndrome.
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40
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Katabathina VS, Vikram R, Olaoya A, Paspulati RM, Nicolas MM, Rao P, Zaheer A, Prasad SR. Neuroendocrine neoplasms of the genitourinary tract in adults: cross-sectional imaging spectrum. Abdom Radiol (NY) 2017; 42:1472-1484. [PMID: 27942847 DOI: 10.1007/s00261-016-1012-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Neuroendocrine (NE) neoplasms of the genitourinary (GU) tract in adults are rare tumors with distinct histopathology and variable biological behavior and imaging findings. They may be primary or metastatic in origin. The spectrum of primary GU tract NE neoplasms includes carcinoid, small cell carcinoma, large cell NE carcinoma, and paraganglioma. The tumors commonly show positivity to specific immunohistochemical markers and characteristic dense-core granules at the ultra-structural level. Although imaging findings are nonspecific and accurate differentiation from the more common malignancies of the individual organs is not possible, cross-sectional imaging modalities play an important role in the diagnosis, staging, and surveillance of these tumors. Somatostatin receptor scintigraphy (octreotide scan) may be useful in the detection and treatment of metastatic disease in select patients. Knowledge of the various NE tumors of the adult GU tract and familiarity with their pathological and imaging findings permit optimal patient management.
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41
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Amine MM, Mohamed B, Mourad H, Majed H, Slim C, Mehdi B, Hela M, Nouri R, Rim K, Tahya B, Nabil MM. Neuroendocrine Testicular Tumors: A Systematic Review and Meta-Analysis. Curr Urol 2017; 10:15-25. [PMID: 28559773 DOI: 10.1159/000447146] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 07/06/2016] [Indexed: 12/13/2022] Open
Abstract
PURPOSE The purpose of this study is to study the main epidemiological, clinical, para clinical, pathological, therapeutic, and evolutionary features of patients with testicular neuroendocrine tumors (TNET). MATERIALS AND METHODS Nine case series and sixteen case reports were identified by searching PubMed database and qualified for inclusion in this study. We added the data of one case treated in the department of urology in Habib Bourguiba Hospital in Sfax, to the published cases. RESULTS A total of 132 cases were collected. Median age at diagnosis was 39 years old (range 10- 83 years). The most common presenting symptom was either a testicular mass or a swelling in 38.46% of cases. Carcinoid syndrome was documented in 10.60% of patients. The clinical examination revealed a palpable mass in 44.70% of patients. This mass was painless and firm in most cases. Serum tumor markers (β-gonadotrophine chorionique humaine, α-feto protein, and lactate dehydrogenase) were within normal limits in all patients except in one case. Most testicular neuroendocrine tumors (76.52%) were primary and pure. The tumors were positive for chromogranin (100%), synaptophysin (100%) and cytokeratin (93.10%). Metastases were detected at time of diagnosis in eight cases (6.06%). The main treatment was radical orchiectomy performed in 127 patients (96.21%). The 5-year overall survival rate was 78.70% and the 5-year specific survival rate was 84.30%. CONCLUSION The diagnosis of testicular carcinoids is based on the immunohistochemistry study. The treatment of choice for these tumors is radical orchiectomy. Somatostatin analogues were reported to be effective in patients with carcinoid syndrome.
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Affiliation(s)
- Mseddi M Amine
- Department of Urology, Habib Bourguiba Hospital, Sfax, Tunisia
| | | | | | - Hamza Majed
- Department of Urology, Habib Bourguiba Hospital, Sfax, Tunisia
| | - Charfi Slim
- Department of anatomic pathology, Habib Bourguiba Hospital, Sfax, Tunisia
| | - Bouassida Mehdi
- Department of Urology, Habib Bourguiba Hospital, Sfax, Tunisia
| | - Mnif Hela
- Department of anatomic pathology, Habib Bourguiba Hospital, Sfax, Tunisia
| | - Rebai Nouri
- Department of Urology, Habib Bourguiba Hospital, Sfax, Tunisia
| | - Kallel Rim
- Department of anatomic pathology, Habib Bourguiba Hospital, Sfax, Tunisia
| | - Boudaouara Tahya
- Department of anatomic pathology, Habib Bourguiba Hospital, Sfax, Tunisia
| | - Mhiri M Nabil
- Department of Urology, Habib Bourguiba Hospital, Sfax, Tunisia
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42
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Kidney Tumor in a von Hippel-Lindau (VHL) Patient With Intensely Increased Activity on 68Ga-DOTA-TATE PET/CT. Clin Nucl Med 2017; 41:970-971. [PMID: 27749408 DOI: 10.1097/rlu.0000000000001393] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Renal and pancreatic cysts and tumors are the most common visceral manifestations of von Hippel-Lindau (VHL) disease, a heritable multisystem cancer syndrome characterized by development of a variety of malignant and benign tumors. We report a case of a VHL patient with multiple renal cystic and complex cystic/solid lesions. The patient underwent Ga-DOTA-TATE-PET/CT showing intensely increased activity by a solid lesion which demonstrated enhancement on both CT and MRI scans, raising high suspicion for malignancy. The presented case indicates application of SSTR-imaging using Ga-DOTA-conjugated peptides in VHL-patients and emphasizes the need for cautious interpretation of renal parenchyma Ga-DOTATATE activity.
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43
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Abstract
Carcinoid tumors rarely originate in the urogenital system. We represent a unique case of primary renal carcinoid tumor which was initially diagnosed as renal cell cancer and 10 years later correctly diagnosed as metastatic renal carcinoid.
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Affiliation(s)
- Hammad Arshad
- Division of Pulmonary and Critical Care, Allegheny General Hospital, Pittsburgh, PA, USA
| | - Parth Rali
- Division of Pulmonary and Critical Care, Allegheny General Hospital, Pittsburgh, PA, USA
| | - Khalid Malik
- Division of Pulmonary and Critical Care, Allegheny General Hospital, Pittsburgh, PA, USA
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44
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Kawasaki K, Kawaguchi Y, Suzuki Y, Tanaka N. Renal neuroendocrine tumour and synchronous pancreas metastasis: histopathological diagnosis using prostatic acid phosphatase. BMJ Case Rep 2016; 2016:bcr-2016-214759. [PMID: 27803081 DOI: 10.1136/bcr-2016-214759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A woman aged 56 years developed 2 synchronous tumours: one, 1.2 cm in diameter at the head of the pancreas; and the other, 4.0 cm in diameter, at the left side of her horseshoe kidney. Preoperative differential diagnosis of these hypovascular lesions included pancreatic ductal carcinoma (PDC) with renal metastasis, PDC with renal angiomyolipoma, renal cell carcinoma with pancreatic metastasis or PDC and renal cell carcinoma. Following pancreaticoduodenectomy and left nephrectomy, both specimens were diagnosed as grade 2 neuroendocrine tumours (NETs). Immunohistochemistry revealed that both were positive for prostatic acid phosphatase (PAP), which is specific to hindgut-derived NET, including renal NET. Accordingly, the renal tumour was diagnosed as the primary lesion, and the pancreatic tumour as a metastasis. To the best of our knowledge, this is the first report of a renal NET with a synchronous pancreas metastasis. Immunohistochemical staining for PAP was a useful diagnostic marker for synchronous NETs in the kidney and pancreas.
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Affiliation(s)
- Keishi Kawasaki
- Department of Surgery, Asahi General Hospital, Chiba, Japan.,Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yoshikuni Kawaguchi
- Department of Surgery, Asahi General Hospital, Chiba, Japan.,Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yoshio Suzuki
- Department of Pathology, Asahi General Hospital, Chiba, Japan
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45
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Primary Carcinoid Tumor of the Renal Pelvis Arising From Intestinal Metaplasia: An Unusual Histogenetic Pathway? Appl Immunohistochem Mol Morphol 2016; 25:e49-e57. [PMID: 27753663 DOI: 10.1097/pai.0000000000000445] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Primary carcinoid tumor of the renal pelvis is a rare neoplasm with few cases reported in the literature. Here we present the clinical and histopathologic findings of a primary carcinoid tumor arising in the left renal pelvis of a horseshoe kidney in a 61-year-old female patient. MATERIALS AND METHODS Pathologic features were evaluated with standard hematoxylin and eosin sections and immunohistochemical studies. A literature review was performed to place our case in context to previous reports. RESULTS The tumor was associated with intestinal metaplasia with high-grade dysplasia and neuroendocrine hyperplasia. Molecular testing for microsatellite instability and loss of heterozygosity were negative. CONCLUSIONS This report portrays a unique presentation of carcinoid tumor arising from intestinal metaplasia of the pelvic urothelium, and supports its histogenesis from urothelial intestinal metaplasia and neuroendocrine hyperplasia.
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46
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Badiu C, Rahnea Nita G, Ciuhu A, Manea C, Smarandache C, Georgescu D, Bedereag S, Cocosila C, Braticevici B, Mehedintu C, Grigorean V. NEUROENDOCRINE RENAL CARCINOMA - THERAPEUTIC AND DIAGNOSTIC ISSUES. ACTA ENDOCRINOLOGICA (BUCHAREST, ROMANIA : 2005) 2016; 12:355-361. [PMID: 31149114 PMCID: PMC6535258 DOI: 10.4183/aeb.2016.355] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Neuroendocrine renal carcinoma represents less than 1% of all primary neoplasia of the kidney. Most frequently poorly differentiated carcinoma is diagnosed in advanced stages and they have an aggressive evolution and limited survival rate. Neuroendocrine carcinomas that arise from the renal pelvis are frequently associated with squamous cell carcinoma or adenocarcinoma. MATERIAL AND METHOD We present the case of a female patient, known for 3 years before with an undefined retroperitoneal lymph node metastasis, being diagnosed at present with a left large cell neuroendocrine renal carcinoma, who initially had lymph node metastasis. RESULTS Until now, 118 cases of primary neuroendocrine renal carcinomas have been reported. A limited number of poorly differentiated neuroendocrine carcinomas have been reported. DISCUSSION Due to the clinical and biological findings, the aggressive evolution with early metastasis of lung and bone, the patient is included in the group of poorly differentiated carcinomas. In these cases, multimodal treatment is a gold standard. After surgical treatment and palliative chemotherapy with platinum salts, we obtained a partial remission of the disease and the control of symptoms. CONCLUSIONS Regarding large cell neuroendocrine carcinoma, the surgical treatment remains the treatment of choice. Chemotherapy can determine limited results, improve the quality of life and enhance the overall survival rate.
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Affiliation(s)
- C.D. Badiu
- Bagdasar Arseni Emergency Hospital - General Surgery Clinic, Bucharest, Romania
- “Carol Davila”University of Medicine and Pharmacy, Bucharest, Romania
| | - G. Rahnea Nita
- “St Luke” Hospital - Oncology Palliative Care, Bucharest, Romania
| | - A.N. Ciuhu
- “St Luke” Hospital - Oncology Palliative Care, Bucharest, Romania
| | - C. Manea
- Bagdasar Arseni Emergency Hospital - General Surgery Clinic, Bucharest, Romania
| | - C.G. Smarandache
- University Emergency Hospital - 4 Clinic of General Surgery, Bucharest, Romania
- “Carol Davila”University of Medicine and Pharmacy, Bucharest, Romania
| | - D.G. Georgescu
- “Colentina” Clinical Hospital - Hematology, Bucharest, Romania
| | - S.I. Bedereag
- Bagdasar Arseni Emergency Hospital - Pathology, Bucharest, Romania
| | - C.L. Cocosila
- Bagdasar Arseni Emergency Hospital - Pathology, Bucharest, Romania
| | - B. Braticevici
- “Prof. Dr. Theodor Burghele” Clinical Hospital - Urology Clinic, Bucharest, Romania
- “Carol Davila”University of Medicine and Pharmacy, Bucharest, Romania
| | - C. Mehedintu
- “Carol Davila”University of Medicine and Pharmacy, Bucharest, Romania
| | - V.T. Grigorean
- Bagdasar Arseni Emergency Hospital - General Surgery Clinic, Bucharest, Romania
- “Carol Davila”University of Medicine and Pharmacy, Bucharest, Romania
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47
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Li B, Cui T, Ban Z, Luo L, Sun L. Primary renal carcinoid tumor: case report and review of the literature. Onco Targets Ther 2016; 9:741-3. [PMID: 26966374 PMCID: PMC4770081 DOI: 10.2147/ott.s88730] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective The aim of this case report is to discuss the clinicopathological features of a patient with a primary renal carcinoid tumor. Methods We report on the clinical and pathological information of one case of a patient with a primary renal carcinoid tumor as well as review relative literature. Results The patient was diagnosed with a renal tumor when she received physical examination, and exhibited no positive symptoms. The diameter of tumor was 5 cm, the cross surface of the tumor was light yellow and firm, and the central part was soft with hemorrhage and necrosis. Immunohistochemical staining revealed strong and diffuse staining with synaptophysin, chromogranin A, and neuron-specific enolase. Conclusion A primary renal carcinoid tumor is extremely rare. Surgical resection is a preferred therapeutic method.
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Affiliation(s)
- Bin Li
- Department of Urology, Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, People's Republic of China
| | - Tongyue Cui
- Department of Urology, People's Hospital of Changle County, Changle, People's Republic of China
| | - Ziqin Ban
- Community Health Center, Qingdao, Shandong, People's Republic of China
| | - Lei Luo
- Department of Urology, Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, People's Republic of China
| | - Lijiang Sun
- Department of Urology, Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, People's Republic of China
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48
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Daboul N, Monga D, Bunker M. Primary renal carcinoid tumour with lung metastasis misdiagnosed as renal cell carcinoma. BMJ Case Rep 2016; 2016:bcr-2015-213432. [PMID: 26951438 DOI: 10.1136/bcr-2015-213432] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
A 58-year-old man with a history of metastatic renal cell carcinoma (RCC) diagnosed 10 years prior, status post right nephrectomy, presented for evaluation of pulmonary nodules. A year after the nephrectomy, he had undergone cutaneous metastasectomy in the right flank area, and a further 2 years later he had had his second cutaneous metastasectomy in the right chest wall. Both cutaneous pathologies had, at the time, shown metastatic neoplasm with histological features compatible with those of the previous renal tumour. He was treated with sorafenib. 3 years later he developed asymptomatic pulmonary nodules, which gradually doubled in size over the next 2.5 years. He underwent bronchoscopy and left lower lobe biopsy. Pathology revealed a metastatic renal carcinoid/neuroendocrine tumour. Second review of the previous renal neoplasm and the cutaneous metastatic pathology showed trabecular architecture, consistent with carcinoid, but mimicking the long parallel arrays that have been described in some cases of papillary RCC.
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Affiliation(s)
- Nour Daboul
- Department of Internal Medicine, Conemaugh Health System, Johnstown, Pennsylvania, USA
| | - Dulabh Monga
- Department of Hematology/Oncology, Allegheny General Hospital, Pittsburgh, Pennsylvania, USA
| | - Mark Bunker
- Department of Pathology, Allegheny General Hospital, Pittsburgh, Pennsylvania, USA
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Guadagno E, De Rosa G, Del Basso De Caro M. Neuroendocrine tumours in rare sites: differences in nomenclature and diagnostics-a rare and ubiquitous histotype. J Clin Pathol 2016; 69:563-74. [PMID: 26915369 DOI: 10.1136/jclinpath-2015-203551] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 02/03/2016] [Indexed: 11/03/2022]
Abstract
The diagnosis of neuroendocrine tumours in typical sites, as gastrointestinal tract and lung, is based upon well-coded criteria that have become familiar to most of the pathologists. Much more difficult is the recognition and allocation of proper nomenclature to be referred to the same histotype in locations where these tumours have a lower incidence. The aim of our review was to provide a quick handbook of the main diagnostic pitfalls known in literature that can interpose in the histopathological examination of neuroendocrine tumours in rare sites (urinary system and male genital organs, female genital organs, head and neck and breast).
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Affiliation(s)
- Elia Guadagno
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Gaetano De Rosa
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
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Abstract
Carcinoid tumor is the classic famous anonym of neuroendocrine neoplasms. Primary renal carcinoid tumors are extremely rare, first described by Resnick and colleagues in 1966, with fewer than a total of 100 cases reported in the literature. Thus, given the paucity of cases, the clinical and histological behavior is not well understood, impairing the ability to predict prognosis. Computed tomography and (occasionally) octreotide studies are used in the diagnosis and followup of these rare entites. A review of 85 cases in the literature shows that no distinctive imaging features differentiate them from other primary renal masses. The lesions tend to demonstrate a hypodense appearance and do not usually enhance in the arterial phases, but can occasionally calcify. Octreotide scans do not seem to help in the diagnosis; however, they are more commonly used in the postoperative followup. In addition, we report a new case of primary renal carcinoid in a horseshoe kidney.
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