1
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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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2
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Kikkawa K, Maruno K, Hazama T, Takahashi T, Yamada Y, Nakashima M, Tamaki M, Ito N. Robotic-assisted partial nephrectomy for a neuroendocrine tumor in a horseshoe kidney: a case report. J Surg Case Rep 2024; 2024:rjae292. [PMID: 38711819 PMCID: PMC11070646 DOI: 10.1093/jscr/rjae292] [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: 04/05/2024] [Accepted: 04/16/2024] [Indexed: 05/08/2024] Open
Abstract
Neuroendocrine tumors of the kidney are exceedingly rare. We report the first case of robotic-assisted partial nephrectomy for such tumors in horseshoe kidneys. A 65-year-old woman was incidentally found to have a 27 mm renal mass in the isthmus of her horseshoe kidney during computed tomography. Based on contrast-enhanced computed tomography results, we initially suspected renal cell carcinoma originating from the horseshoe kidney. Subsequently, robotic-assisted partial nephrectomy with isthmus transection was performed. Intraoperatively, we adjusted the port position for camera insertion and the patient's positioning to facilitate better visualization for dorsal isthmus and vessel dissection. Pathological examination and immunohistochemical analysis revealed a well-differentiated neuroendocrine tumor. Therefore, robotic-assisted partial nephrectomy is a safe and effective approach for managing neuroendocrine tumors in the isthmus of horseshoe kidneys. Given the nonspecific clinical presentation of renal neuroendocrine tumors and their rarity, the optimal management of these tumors remains controversial.
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Affiliation(s)
- Kazuro Kikkawa
- Department of Urology, Japanese Red Cross Wakayama Medical Center, 4-20, Komatsubaradori, Wakayama 640-8558, Japan
| | - Kouhei Maruno
- Department of Urology, Japanese Red Cross Wakayama Medical Center, 4-20, Komatsubaradori, Wakayama 640-8558, Japan
| | - Tatsuya Hazama
- Department of Urology, Japanese Red Cross Wakayama Medical Center, 4-20, Komatsubaradori, Wakayama 640-8558, Japan
| | - Toshifumi Takahashi
- Department of Urology, Japanese Red Cross Wakayama Medical Center, 4-20, Komatsubaradori, Wakayama 640-8558, Japan
| | - Yuya Yamada
- Department of Urology, Japanese Red Cross Wakayama Medical Center, 4-20, Komatsubaradori, Wakayama 640-8558, Japan
| | - Masakazu Nakashima
- Department of Urology, Japanese Red Cross Wakayama Medical Center, 4-20, Komatsubaradori, Wakayama 640-8558, Japan
| | - Masahiro Tamaki
- Department of Urology, Japanese Red Cross Wakayama Medical Center, 4-20, Komatsubaradori, Wakayama 640-8558, Japan
| | - Noriyuki Ito
- Department of Urology, Japanese Red Cross Wakayama Medical Center, 4-20, Komatsubaradori, Wakayama 640-8558, Japan
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3
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Shokei S, Nagase M, Araki A, Nakajima H, Wada K, Niino D. A Case Report of Carcinoid With Teratoma Arising From the Renal Hilum. Int J Surg Pathol 2024:10668969241228299. [PMID: 38332632 DOI: 10.1177/10668969241228299] [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: 02/10/2024]
Abstract
Teratoma is a germ cell tumor composed of 2 or 3 germ cell layers, and it can occur in various parts of the human body. However, teratomas of the renal hilum are particularly rare, and those complicated by carcinoids are even more uncommon. Herein, we report the example of an asymptomatic 49-year-old woman in whom a tumor in the right renal hilum was unexpectedly discovered on imaging. Histological examination revealed a carcinoid tumor arising from a simple cyst composed of teratomatous tissue. Although the tumor was located in the renal hilum and touched the renal parenchyma, it appeared independent of the kidney and urinary tract. This report highlights the rare occurrence of teratomas with carcinoids and provides insights into their origins.
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Affiliation(s)
- Sachiko Shokei
- Pathology Division, Shimane University Hospital, Shimane, Japan
| | - Mamiko Nagase
- Department of Organ Pathology, Shimane University Faculty of Medicine, Shimane, Japan
| | - Asuka Araki
- Pathology Division, Shimane University Hospital, Shimane, Japan
| | - Hirochika Nakajima
- Department of Urology, Shimane University Faculty of Medicine, Shimane, Japan
| | - Koichiro Wada
- Department of Urology, Shimane University Faculty of Medicine, Shimane, Japan
| | - Daisuke Niino
- Department of Functional Pathology, Shimane University Faculty of Medicine, Shimane, Japan
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4
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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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5
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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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6
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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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7
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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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8
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Chen Y, Shu Y, He L, Wu K. Primary renal carcinoid tumors: Three case reports. Medicine (Baltimore) 2021; 100:e24714. [PMID: 33663082 PMCID: PMC7909218 DOI: 10.1097/md.0000000000024714] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 01/19/2021] [Accepted: 01/21/2021] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Primary renal carcinoid tumors are very rare and only about 100 cases have been reported in the medical literature. There are even fewer articles on the imaging manifestations of primary renal carcinoid tumors. PATIENT CONCERNS We present 3 cases of patients with lumbago and hematuria. These were cases of primary renal carcinoid tumors with initial suspicion of suprarenal epithelioma. DIAGNOSES Renal lesions were detected on abdomen computed tomography (CT) imaging. The 3 cases presented as solid/cystic solid renal mass with uniform or non-uniform density, calcification in the mass, and enhanced heterogeneity. INTERVENTIONS The laparoscopic partial/radical nephrectomy were performed. OUTCOMES The postoperative histological diagnosis were primary renal carcinoid tumors. Case 2 been lost to follow-up in 3 patients, and the other 2 patients (Case 1 and 3) are still alive. Case 1 had intrahepatic metastases. LESSONS Primary renal carcinoid tumors mostly present as solid mass/cystic solid mass with calcification and delayed enhancement of heterogeneity on CT imaging, but the diagnosis depends on pathological diagnosis. Hence, raising awareness of the CT features of the rare tumor in the kidney may broaden the knowledge base of radiologists.
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9
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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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10
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Zhang M, Guo CC. Neuroendocrine Kidney Tumors. KIDNEY CANCER 2020. [DOI: 10.1007/978-3-030-28333-9_10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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11
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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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12
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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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13
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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: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [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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14
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Rindi G, Klimstra DS, Abedi-Ardekani B, Asa SL, Bosman FT, Brambilla E, Busam KJ, de Krijger RR, Dietel M, El-Naggar AK, Fernandez-Cuesta L, Klöppel G, McCluggage WG, Moch H, Ohgaki H, Rakha EA, Reed NS, Rous BA, Sasano H, Scarpa A, Scoazec JY, Travis WD, Tallini G, Trouillas J, van Krieken JH, Cree IA. A common classification framework for neuroendocrine neoplasms: an International Agency for Research on Cancer (IARC) and World Health Organization (WHO) expert consensus proposal. Mod Pathol 2018; 31:1770-1786. [PMID: 30140036 PMCID: PMC6265262 DOI: 10.1038/s41379-018-0110-y] [Citation(s) in RCA: 600] [Impact Index Per Article: 100.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 06/14/2018] [Accepted: 06/14/2018] [Indexed: 02/08/2023]
Abstract
The classification of neuroendocrine neoplasms (NENs) differs between organ systems and currently causes considerable confusion. A uniform classification framework for NENs at any anatomical location may reduce inconsistencies and contradictions among the various systems currently in use. The classification suggested here is intended to allow pathologists and clinicians to manage their patients with NENs consistently, while acknowledging organ-specific differences in classification criteria, tumor biology, and prognostic factors. The classification suggested is based on a consensus conference held at the International Agency for Research on Cancer (IARC) in November 2017 and subsequent discussion with additional experts. The key feature of the new classification is a distinction between differentiated neuroendocrine tumors (NETs), also designated carcinoid tumors in some systems, and poorly differentiated NECs, as they both share common expression of neuroendocrine markers. This dichotomous morphological subdivision into NETs and NECs is supported by genetic evidence at specific anatomic sites as well as clinical, epidemiologic, histologic, and prognostic differences. In many organ systems, NETs are graded as G1, G2, or G3 based on mitotic count and/or Ki-67 labeling index, and/or the presence of necrosis; NECs are considered high grade by definition. We believe this conceptual approach can form the basis for the next generation of NEN classifications and will allow more consistent taxonomy to understand how neoplasms from different organ systems inter-relate clinically and genetically.
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Affiliation(s)
- Guido Rindi
- Istituto di Anatomia Patologica, Università Cattolica-Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
| | - David S Klimstra
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Behnoush Abedi-Ardekani
- International Agency for Research on Cancer (IARC), World Health Organization (WHO), Lyon, France
| | - Sylvia L Asa
- University Health Network, University of Toronto, Toronto, ON, Canada
| | | | - Elisabeth Brambilla
- CHUGA, UniversitéUGA, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Klaus J Busam
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ronald R de Krijger
- Department of Pathology, University Medical Center Utrecht and Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | | | | | | | - Günter Klöppel
- Department of Pathology, Technical University of München, München, Germany
| | - W Glenn McCluggage
- Department of Pathology, Belfast Health and Social Care Trust, Belfast, UK
| | - Holger Moch
- University Hospital Zurich, Zurich, Switzerland
| | - Hiroko Ohgaki
- International Agency for Research on Cancer (IARC), World Health Organization (WHO), Lyon, France
| | | | | | - Brian A Rous
- National Cancer Registration and Analysis Service, Fulbourn, UK
| | - Hironobu Sasano
- Department of Pathology, Tohoku University School of Medicine, Sendai, Japan
| | - Aldo Scarpa
- Section of Pathology, ARC-Net Research Center and Department of Diagnostics and Public Health, University and Hospital Trust of Verona, Verona, Italy
| | - Jean-Yves Scoazec
- Departement of Pathology, Gustave Roussy Cancer Campus, Villejuif, France
| | - William D Travis
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Giovanni Tallini
- University Medical Center, University of Bologna, Bologna, Italy
| | | | - J Han van Krieken
- Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Ian A Cree
- International Agency for Research on Cancer (IARC), World Health Organization (WHO), Lyon, France.
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15
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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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16
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Abstract
Abstract
Horseshoe kidney is an inborn renal fusion anomaly. It is frequently associated with renal stones and infections. The diagnosis is made using imaging methods - ultrasound, X-ray of the abdomen and intravenous pyelography, computed tomography (CT), magnetic resonance imaging (MRI) and radionuclide investigations. The diagnosis sometimes is hard, especially when other abnormalities are present, i.e. hydronephrosis, nephrolithiasis, stenosis of the ureteropelvic junction, etc. The authors present a male patient with horseshoe kidney and unilateral hydronephrosis due to obstruction of the ureteropelvic junction and discuss the diagnosis of horseshoe kidney and the diagnostic approach in such patients.
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17
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Santiago T, Clay MR, Azzato E, Newman S, Fernandez-Pineda I, Nichols KE, Zhang J, Downing JR, Davidoff A, Brennan RC, Ellison DW. Clear cell sarcoma of kidney involving a horseshoe kidney and harboring EGFR internal tandem duplication. Pediatr Blood Cancer 2017; 64. [PMID: 28440018 DOI: 10.1002/pbc.26602] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 03/20/2017] [Indexed: 12/27/2022]
Abstract
Clear cell sarcoma of kidney (CCSK) is a rare renal malignancy, previously unreported in horseshoe kidney (HSK). B-cell lymphoma 6 corepressor (BCOR) gene internal tandem duplication (ITD) was identified as a recurrent somatic alteration in approximately 85% of CCSKs. This and the YWHAE-NUTM2B/E fusion, the second most common recurrent molecular alteration in CCSK (10%), are considered to be mutually exclusive. However, there is a subset of CCSKs that do not harbor either the BCOR-ITD or YWHAE-NUTM2 translocation and lack known molecular alterations. Herein, we report the first case of CCSK arising in HSK and harboring epidermal growth factor receptor ITD.
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Affiliation(s)
- Teresa Santiago
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Michael R Clay
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Elizabeth Azzato
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Scott Newman
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | | | - Kim E Nichols
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Jinghui Zhang
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - James R Downing
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Andrew Davidoff
- Department of Surgery, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Rachel C Brennan
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - David W Ellison
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee
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18
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Zhou Y, Wei S. Not Your Typical Renal Cyst. Am J Med 2017; 130:e429-e432. [PMID: 28687266 DOI: 10.1016/j.amjmed.2017.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 06/14/2017] [Accepted: 06/15/2017] [Indexed: 11/17/2022]
Affiliation(s)
- Yaolin Zhou
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City; Department of Pathology, University of Alabama at Birmingham.
| | - Shi Wei
- Department of Pathology, University of Alabama at Birmingham
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19
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Percutaneous Cryoablation of the Horseshoe Kidney: An Initial Experience. J Vasc Interv Radiol 2017; 28:498-501. [DOI: 10.1016/j.jvir.2016.10.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 10/26/2016] [Accepted: 10/26/2016] [Indexed: 01/20/2023] Open
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20
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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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21
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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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22
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Gauthé M, Lièvre A, Alberini JL. Primary Neuroendocrine Tumor in a Horseshoe Kidney With Positive 111In-Pentetreotide Somatostatin Receptor Scintigraphy and Negative 18F-DOPA PET/CT. Clin Nucl Med 2015. [DOI: 10.1097/rlu.0000000000000911] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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23
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24
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A case of primary renal carcinoid tumor. Case Rep Urol 2015; 2015:736213. [PMID: 25685590 PMCID: PMC4320909 DOI: 10.1155/2015/736213] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 11/28/2014] [Accepted: 01/05/2015] [Indexed: 11/17/2022] Open
Abstract
Primary renal carcinoid tumors are extremely rare kidney lesions, with fewer than 100 reported cases previously. We describe a 75-year-old man with an incidentally detected cystic renal mass. Computed tomography showed a 3 cm tumor with a cystic component enhanced with contrast. No evidence of metastasis was detected. We treated the patient with radical nephrectomy. Pathological examinations revealed a cellular arrangement specific to carcinoid tumor and positive for chromogranin A, neural cell adhesion molecule, and somatostatin receptor type 2. The tumor cells had a mitotic count of 4 mitoses/10 high-power fields, and the level of the proliferation marker Ki-67 was 5%. The pathological diagnosis was renal neuroendocrine tumor grade 2. No local recurrence and no systemic metastasis were detected during the 18-month follow-up period. To our knowledge, this is the 6th case of renal neuroendocrine grade 2 tumor reported thus far.
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25
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Primary carcinoid tumour of the kidney: a review of the literature. Adv Urol 2013; 2013:579396. [PMID: 23997766 PMCID: PMC3755439 DOI: 10.1155/2013/579396] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Accepted: 05/19/2013] [Indexed: 12/31/2022] Open
Abstract
Context. Primary renal carcinoid tumours are rare. Their pathogenesis is unknown and the clinical presentation is similar to other renal tumours thus posing diagnostic dilemmas for clinicians. Objectives. To review the literature for case reports of primary renal carcinoids. Methods. Literature was extensively searched for case reports for primary renal carcinoids. Reports of metastatic carcinoids to the kidneys were excluded. Results. Approximately less than 90 cases of primary carcinoid tumours of the kidney have been reported in the literature. A total of 29 cases of primary renal carcinoids were reviewed. The mean age of presentation was 48 years (range 29–75) with both right kidney (48.3%) and left kidney (44.8%) being equally affected. 28.6% of the cases reviewed were diagnosed as an incidental finding. The mean followup time was 20 months with 73.1% of patients without evidence of disease after surgical treatment (radical or partial nephrectomy). Primary carcinoid tumours of the kidney are often well differentiated tumours. They are often misdiagnosed because of their rarity and similar presentation with other renal tumours. Conclusions. Primary carcinoid tumours of the kidney are rare tumours with an indolent course with frequent metastasis. Metastatic work up and followup is required in their management.
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26
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Korkmaz T, Seber S, Yavuzer D, Gumus M, Turhal NS. Primary renal carcinoid: treatment and prognosis. Crit Rev Oncol Hematol 2013; 87:256-64. [PMID: 23478151 DOI: 10.1016/j.critrevonc.2013.02.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2012] [Revised: 11/28/2012] [Accepted: 02/13/2013] [Indexed: 12/20/2022] Open
Abstract
Primary carcinoid tumors of the kidney are very rare, malignant tumors consisting of neuroendocrine cells. The pathogenesis of renal carcinoid is unclear because neuroendocrine cells are not normally found in adult renal parenchyma. Electron microscopy, immunohistochemistry, octreotide scan, positron emission tomography along with conventional radiographic imaging techniques are used in diagnosis and follow-up. Presenting symptoms usually include flank pain and haematuria. Early stage disease is treated with surgery only. However, randomized trials are lacking because of the very low number of reported cases. Thus, the role of debulking surgery, chemotherapy, radiotherapy, octreotide and targeted therapy in the management of advanced disease remains an open question. In this article the clinicopathologic features and prognosis of this very rare disease along with treatment outcomes of the reported cases are reviewed. In addition, we report a new case of a metastatic primary renal atypical carcinoid tumor treated with octreotide therapy.
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Affiliation(s)
- Taner Korkmaz
- Department of Medical Oncology, Dr. Lutfi Kirdar Kartal Education and Research Hospital, Istanbul, Turkey.
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27
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[A case of renal carcinoid with local recurrence and multiple lymph node metastases 4 years after partial nephrectomy]. Nihon Hinyokika Gakkai Zasshi 2013; 103:665-70. [PMID: 23342926 DOI: 10.5980/jpnjurol.103.665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Primary renal carcinoid is an uncommon tumor. We report a case of local recurrence and multiple lymph node metastases of renal carcinoid 4 years after partial nephrectomy in a 64-year-old man. He was incidentally found to have a mass lesion in the right kidney and right partial nephrectomy was performed 4 years ago. Histological examination including immunohistochemical studies confirmed the diagnosis of the atypical primary renal carcinoid. After 4 years of follow up, abdominal ultrasonography and computed tomography demonstrated a local recurrence and multiple lymph node metastases around the inferior vena cava. He underwent right radical nephrectomy with paraaortic and right renal hilum lymphadenectomy. Histological appearance showed that recurrence of the atypical renal carcinoid. Four of the resected five lymph nodes were positive for metastasis. Unexpectedly, two tiny renal cell carcinomas were also found from the right kidney. The patient remains free from disease recurrence for 2 months post re-operation. This case is the 43rd report of renal carcinoid tumor in Japan.
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28
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Abstract
Primary neuroendocrine (NE) tumors of the kidney (PNRTs) are rare and frequently mistaken for other renal and urothelial cancers. We evaluated morphological and molecular findings of 11 PNRTs classified according to the World Health Organization classification of lung NE tumors. Patients included 5 men and 6 women with a median age of 50 years. These tumors occurred in the left (5/11), right (3/11), and horseshoe (1/11) kidney. The histologic patterns were predominantly solid, trabecular, and pseudoglandular. Lymphovascular invasion and calcification were found in 3 and 1 cases, respectively. There were 2 atypical and 9 typical carcinoids. At the time of surgery, 2 patients with atypical carcinoids had hepatic metastasis, and 1 of the typical carcinoid patients had lymph node metastasis. All cases showed <1% proliferative rate, except 2 cases with hepatic metastasis, which showed 3% to 5% with MIB1/Ki-67 immunostaining. Immunostainings were frequently positive for synaptophysin, chromogranin, CD56, CD99, and neuron-specific enolase. Follow-up data (average 4 years) were available for 6 patients. Two patients with distant metastasis were alive with disease, and four patients with no metastasis were alive without disease. We evaluated the association of PNRT and loss of heterozygosity (LOH) on chromosome 3p21 and found LOH in 2 of 3 cases. However, the comparative genomic hybridization study (2/2) did not demonstrate significant chromosomal imbalances. We conclude that PNRTs are positive for NE markers and may have LOH on chromosome 3p21. PNRTs should be classified as NE tumors in other sites, and proliferative rate can be an indicator of aggressive behavior/metastasis.
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29
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Primary micro neuroendocrine tumor arising in a horseshoe kidney with cyst: report of a case and review of literature. Diagn Pathol 2012; 7:126. [PMID: 22999194 PMCID: PMC3487839 DOI: 10.1186/1746-1596-7-126] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2012] [Accepted: 09/13/2012] [Indexed: 11/12/2022] Open
Abstract
Abstract Neuroendocrine tumors are a heterogeneous group of neoplasms that arise from neuroendocrine cells. Primary renal neuroendocrine tumors are among the most unusual of all renal neoplasms, since neuroendocrine cells are not found within normal renal parenchyma. Here, a case of primary micro neuroendocrine tumor (about 4.7 mm*2 mm) arising in the horseshoe kidney with a cyst of a 45-year-old man was reported and a literature review was written. Virtual Slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2121156944757267
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30
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Primary neuroendocrine carcinoma of the kidney. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2012; 157:257-60. [PMID: 23073523 DOI: 10.5507/bp.2012.053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2011] [Accepted: 04/25/2012] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The objective of the study was to report a rare case of primary neuroendocrine carcinoma of the right kidney in a 36 year old male. METHODS The patient was clinically assessed; CT and OctreoScan scintigraphy were performed and levels of 5-HIAA, vanillylmandelic acid and NSE were determined. The tumor and metastases were histologically and immunohistochemically examined. RESULTS The imaging methods showed a cystic tumor in the lower pole of the right kidney. Macroscopically, the entire tumor was sized 8x8x7 cm. Histologically, it was made up of ribbon-line or trabecular patterns of tumor cells. Occasional adenomatoid and cystic structures were present. The tumor cell nuclei were round or oval, with no irregularities and fine lumpy chromatin. The mitotic count was < 1 /10HPF and the proliferation marker Ki-67 was < 1 % of tumor cells. Immunohistochemically, the tumor cells were positive with antibodies against chromogranin A, synaptophysin, CD56 (focally), cytokeratins AE1-AE3 (focally), vimentin (most cells), glucagon (focally), and pancreatic polypeptide (PP; focally). Antibodies against serotonin, somatostatin, gastrin, vasoactive intestinal polypeptide (VIP) and calcitonin did not react with the tumor. The results of biochemical markers (5-HIAA, vanillylmandelic acid and NSE) did not correlate with development or treatment of the tumor. CONCLUSIONS Primary neuroendocrine carcinoma of the kidney was diagnosed both histologically and immunohistochemically. The patient was clinically investigated using CT and OctreoScan scintigraphy. Within two years from nephrectomy, metastases were found in the right humerus and retrocaval lymph nodes. The metastatic lesions were surgically removed. Currently, the patient's condition is good, with no tumor progression detected.
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31
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Jeung JA, Cao D, Selli BW, Clapp WL, Oliai BR, Parwani AV, Allan RW. Primary renal carcinoid tumors: clinicopathologic features of 9 cases with emphasis on novel immunohistochemical findings. Hum Pathol 2011; 42:1554-61. [DOI: 10.1016/j.humpath.2010.12.019] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2010] [Revised: 12/18/2010] [Accepted: 12/22/2010] [Indexed: 10/18/2022]
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32
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Kato Y, Nakamura K, Yamada Y, Nishikawa G, Yoshizawa T, Zennnami K, Katsuda R, Tobiume M, Aoki S, Taki T, Honda N. A rare case of metastatic renal carcinoid. BMC Urol 2010; 10:22. [PMID: 21144059 PMCID: PMC3016340 DOI: 10.1186/1471-2490-10-22] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2010] [Accepted: 12/14/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Carcinoid is an endocrine cell tumor with low-grade atypia, which is generally a low-grade malignant cancer with a good prognosis. Metastatic renal carcinoid is even rarer than primary carcinoids. CASE PRESENTATION We present our experience of a patient with metastatic renal carcinoid from the gastrointestinal tract. CONCLUSIONS The carcinoid tumor of the kidney in our patient, who had a history of liver metastasis from rectal carcinoid, was considered metastatic based on the pathological findings.
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Affiliation(s)
- Yoshiharu Kato
- Department of Urology, Aichi Medical University School of Medicine, Nagakute, Aichi 480-1195, Japan
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34
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Chiang MC, Ou YC, Yang CR, Cheng CL, Ho HC. Primary renal carcinoid tumor with multiple metastases. J Chin Med Assoc 2010; 73:435-7. [PMID: 20728856 DOI: 10.1016/s1726-4901(10)70093-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2009] [Accepted: 05/12/2010] [Indexed: 12/01/2022] Open
Abstract
Primary renal carcinoid tumors are extremely rare lesions of the kidney, with fewer than 60 cases reported previously. Here, we present the case of a 46-year-old man who had primary renal carcinoid tumor with multiple liver, para-aortic lymph node and bony metastases when he was diagnosed initially. In consideration of life quality, we performed cytoreductive surgery only. In the following year, the patient did not have any severe cancer-related morbidity.
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Affiliation(s)
- Ming-Chieh Chiang
- Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C
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35
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Kuroda N, Alvarado-Cabrero I, Sima R, Hes O, Michal M, Kinoshita H, Matsuda T, Ohe C, Sakaida N, Uemura Y, Lee GH. Renal carcinoid tumor: An immunohistochemical and molecular genetic study of four cases. Oncol Lett 2010; 1:87-90. [PMID: 22966261 DOI: 10.3892/ol_00000015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2009] [Accepted: 10/12/2009] [Indexed: 12/16/2022] Open
Abstract
Few genetic studies of renal carcinoid tumor have been conducted thus far. We performed immunohistochemical and genetic examinations on four renal carcinoid tumors. Histologically, the tumors consisted of neoplastic cells with round to oval nuclei. Various growth patterns such as tightly packed cords and trabeculae, ribbon-like, trabecular, sheet-like or solid growth were observed. Nuclear chromatin showed a coarse and granular pattern. Immunohistochemically, tumors were positive for chromogranin A and synaptophysin. In the fluorescence in situ hybridization study, three of four tumors revealed monosomy of chromosome 3 (D3Z1), but one tumor showed monosomy of chromosome 13 (D13S319/13q34). Using PCR amplification and fragment analysis of three microsatellite markers (D3S1300, D3S666 and D3S1768) of chromosome arm 3p, one tumor showed loss of heterozygosity at D3S1300 and D3S1768, one tumor was not informative and the analysis of two tumors failed due to low DNA quality. In three cases, the VHL gene status was tested. Two tumors showed wild-type, but the analysis of one tumor failed to provide adequate results. In conclusion, we suggest that the abnormality of chromosome 3 is involved in the pathogenesis of renal carcinoid tumor.
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Affiliation(s)
- Naoto Kuroda
- Department of Diagnostic Pathology, Kochi Red Cross Hospital, Kochi 780-8562, Japan
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36
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Olweny EO, Hsieh MH, Buckley JC, McAninch JW. Invasive neuroendocrine tumor of the kidney: a case report. Rare Tumors 2009; 1:e37. [PMID: 21139916 PMCID: PMC2994476 DOI: 10.4081/rt.2009.e37] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2009] [Accepted: 09/16/2009] [Indexed: 11/23/2022] Open
Abstract
Neuroendocrine tumors (NETs) involve the genitourinary system in less than 1% of cases, with primary renal carcinoids comprising only 19% of reported genitourinary NETs (56 cases worldwide). We report a case of a renal NET presenting as a large renal mass with extensive local invasion, requiring definitive radical en bloc resection via a thoracoabdominal approach.
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Affiliation(s)
- Ephrem O Olweny
- Departments of Urology: University of California, San Francisco
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37
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Mazzucchelli R, Morichetti D, Lopez-Beltran A, Cheng L, Scarpelli M, Kirkali Z, Montironi R. Neuroendocrine tumours of the urinary system and male genital organs: clinical significance. BJU Int 2009; 103:1464-70. [PMID: 19254281 DOI: 10.1111/j.1464-410x.2009.08451.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Two basic types of neuroendocrine (NE) tumours with diverse clinicopathological features and outcome are identified in the urinary system and male genital organs: carcinoid tumour and neuroendocrine carcinoma. Carcinoid, a rare tumour, occurs in the kidney, bladder, prostate and testis. It is morphologically, histochemically, immunohistochemically and ultrastructurally similar to its counterpart in other organs, such as lung or gastrointestinal tract. Metastases can be detected at the initial evaluation, although they have been reported up to several years after removal, emphasizing the need for a long-term follow-up. NE carcinoma occurs in the kidney, bladder and prostate, and includes small cell carcinoma (SCC) and large cell NE carcinoma (LCNEC), the latter being exceedingly rare. Both show the morphology and immunophenotype of NE carcinoma originating in other organs. Although the occurrence is rare, it is highly aggressive.
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Affiliation(s)
- Roberta Mazzucchelli
- Pathological Anatomy, Polytechnic University of the Marche Region, School of Medicine, United Hospitals, Ancona, Italy
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38
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Glodny B, Petersen J, Hofmann KJ, Schenk C, Herwig R, Trieb T, Koppelstaetter C, Steingruber I, Rehder P. Kidney fusion anomalies revisited: clinical and radiological analysis of 209 cases of crossed fused ectopia and horseshoe kidney. BJU Int 2008; 103:224-35. [PMID: 18710445 DOI: 10.1111/j.1464-410x.2008.07912.x] [Citation(s) in RCA: 93] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To analyse the morphological appearance of horseshoe kidneys (HKs) and crossed fused ectopia (CFE) and to assess the frequency and clinical significance of associated anomalies and diseases. PATIENTS AND METHODS The findings and images of 209 patients with fused kidneys (FKs) were reviewed; in all, 244 scans from computed tomography (CT), 233 ultrasonograms and 89 micturition cysto-urethrograms, urograms, magnetic resonance images and angiograms were taken. RESULTS HKs (found in one of 474 abdominal CT scans) and CFEs (found in one of 3078 CT scans) showed a high variability of vasculature that could not be classified. However, some generalized conclusions were possible about the renal vasculature (430 arteries in 103 kidneys). Variants of the most cephalad artery of both sides were rare. The second artery on the right had a pre-caval course. The origins of vessels located further caudal were more ventral. CFEs were anatomically different from HKs with respect to lower position, greater axial rotation, smaller pelvic width, more caudal origin, and fewer vessels, but not in accompanying anomalies. Severe anomalies or malformations were found in 23% of patients, with half of them in the urogenital system. Malformations were found considerably more often in children than in adults. There was no increased incidence of diseases such as stones or inflammation of the renal pelvis. CONCLUSION Concomitant anomalies and diseases were equally frequent for HK and CFE, but less frequent than generally assumed. Individual cases of complex anatomical situations require special examination strategies, and CT appears to be the most reliable imaging method.
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Affiliation(s)
- Bernhard Glodny
- Department of Radiology, Innsbruck Medical University, Innsbruck, Austria.
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39
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O'Brien J, Buckley O, Doody O, Ward E, Persaud T, Torreggiani W. Imaging of horseshoe kidneys and their complications. J Med Imaging Radiat Oncol 2008; 52:216-26. [PMID: 18477115 DOI: 10.1111/j.1440-1673.2008.01950.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Horseshoe kidney is the most common renal fusion anomaly and the patients are prone to a variety of complications, such as stone disease, pelviureteric junction (PUJ) obstruction, trauma, infections and tumours. As result of the abnormal anatomy of a horseshoe kidney, imaging and treatment pathways vary substantially from the normal kidney. In this review, we describe the role of modern imaging in depicting horseshoe kidneys and their complications, in tandem with the role the interventional radiologist plays in treating these patients.
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Affiliation(s)
- J O'Brien
- Department of Radiology, Adelaide and Meath Incorporating the National Children's Hospital, Dublin, Ireland.
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40
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Kuroda N, Katto K, Tamura M, Shiotsu T, Hes O, Michal M, Nagashima Y, Ohara M, Hirouchi T, Mizuno K, Hayashi Y, Lee GH. Carcinoid tumor of the renal pelvis: Consideration on the histogenesis. Pathol Int 2007; 58:51-4. [PMID: 18067641 DOI: 10.1111/j.1440-1827.2007.02188.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Naoto Kuroda
- Department of Diagnostic Pathology, Kochi Red Cross Hospital, Kochi City, Japan.
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41
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Hansel DE, Epstein JI, Berbescu E, Fine SW, Young RH, Cheville JC. Renal carcinoid tumor: a clinicopathologic study of 21 cases. Am J Surg Pathol 2007; 31:1539-44. [PMID: 17895755 DOI: 10.1097/pas.0b013e318042d596] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Renal carcinoid tumors are exceedingly rare tumors that have been primarily documented as case reports in the literature. In this study, we report a series of 21 renal carcinoid tumors, with emphasis on histopathologic features and clinical outcomes. Patient age ranged from 27 to 78 years (average 52 y). The majority of specimens consisted of radical nephrectomies with or without associated lymph node dissection. Nine tumors were present in the left kidney and 10 were present in the right; location was not available for 2 specimens. No anatomic region of the kidney appeared to be preferentially involved. Twenty tumors were unifocal and ranged in size from 2.6 to 17 cm (average 6.4 cm), and 1 tumor presented as 2 nodules measuring 1 and 2.8 cm. Four patients had a documented history of a horseshoe kidney. Two patients had a history of renal calculi and 1 patient had a history of urothelial carcinoma 8 years prior. Presenting symptoms and clinical findings included back or flank pain (n=6/9), enlarging abdominal mass or fullness (n=2/9), hematuria (n=2/9), and anemia (n=1/9). Twelve patients had concurrent metastases at the time of initial surgery to sites including lymph nodes (n=11/12), liver (n=5/12), bone (n=1/12), and lung (n=1/12). One additional patient developed subsequent metastases to the liver within 6 months of surgery. Examination of the specimens identified carcinoid tumor with a variety of patterns including tightly packed cords and trabeculae with minimal stroma (n=17/21), trabecular growth with prominent stroma (n=4/21), focal solid nests (n=4/21), focal glandlike lumina (n=4/21). The border between tumor and normal kidney was sharply defined in most cases (n=16/21), although focal infiltration was noted in 5/21 cases. Extracapsular extension was documented in 11/21 (52%) cases. Calcifications were present in 5/21 cases. Mitotic activity, measured as mitoses per 10 high-power fields, ranged from 0 to 2 in most cases, with 1 case demonstrating up to 4 mitotic figures per single high-power field. Necrosis was absent in all cases. Immunostains were frequently positive for synaptophysin (n=18/20), chromogranin (n=13/20), Cam5.2 (n=14/16), and vimentin (n=12/15). CK7 was focally positive in a small subset of cases (n=3/18) and CK20 was positive in 1 case. TTF-1 and WT-1 were negative in all cases examined. Clinical follow-up was available on 15 patients and ranged from 3 months to 11 years. One patient died of disease at 8 months after surgery and 1 patient died without disease at 11 years after surgery. Of the remaining patients, 7 patients were alive without disease and 6 patients were alive with disease. Additional metastases developed in 4 patients and included metastases to the liver and bone.
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Affiliation(s)
- Donna E Hansel
- Department of Pathology and Laboratory Medicine, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
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42
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Abstract
Neuroendocrine differentiation in tumors of the upper and lower urinary tracts, prostate, and testis is rare. The current review surveys the most significant pathologic and clinical features of primary neuroendocrine lesions at these sites, with emphasis on the cell types from which they derive. As many tumors in this spectrum often bear strong morphologic resemblance to similar neoplasms in other organs, the importance of considering secondary involvement of the genitourinary tract cannot be overstated.
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Affiliation(s)
- Samson W Fine
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY 10021, USA.
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43
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Bhalla R, Popp A, Nassar A. Case report: Metastatic renal carcinoid to the thyroid diagnosed by fine needle aspiration biopsy. Diagn Cytopathol 2007; 35:597-600. [PMID: 17703444 DOI: 10.1002/dc.20706] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We report a case of primary renal carcinoid arising in a horseshoe kidney. To the best of our knowledge this is the first case to be reported in the cytology literature, which has been diagnosed by fine needle aspiration (FNA). A 32-year-old male, presented to the Emory University Hospital, with a renal mass arising in a horseshoe kidney; along with a thyroid mass. FNA of the renal mass resulted in an initial diagnosis of renal cell carcinoma, unclassified. A thyroid aspiration was attempted later, and revealed a neuroendocrine morphology. This was compared with the renal aspiration and both of them were found to have similar morphology. With the help of immunostains, a diagnosis of renal carcinoid tumor metastatic to the thyroid was made. Thus, we demonstrate that renal carcinoid, being a rare entity, can pose a diagnostic challenge.
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Affiliation(s)
- Ritu Bhalla
- Department of Pathology and Laboratory Medicine, Emory University Hospital, School of Medicine, Atlanta, Georgia 30322, USA
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Romero FR, Rais-Bahrami S, Permpongkosol S, Fine SW, Kohanim S, Jarrett TW. Primary Carcinoid Tumors of the Kidney. J Urol 2006; 176:2359-66. [PMID: 17085102 DOI: 10.1016/j.juro.2006.07.129] [Citation(s) in RCA: 89] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2005] [Indexed: 11/29/2022]
Abstract
PURPOSE We describe in detail the features of carcinoid tumors of the kidney. We evaluated possible prognostic factors. MATERIALS AND METHODS An extensive search was performed in the medical literature regarding primary carcinoid tumors of the kidney. Epidemiological, clinical, diagnostic, histopathological, therapeutic and prognostic data were evaluated. Several potential risk factors were compared with the incidence of metastases and clinical outcome of the patients. RESULTS A total of 56 case reports were reviewed. Median patient age was 49 years. Horseshoe kidneys were present in 17.8% of cases. Incidental diagnosis was made in 28.6% of patients. The most common symptom was abdominal or flank pain and neuroendocrine syndromes occurred with only 12.7% of primary renal carcinoid tumors. Of the patients 73.6% presented with tumors larger than 4 cm. Metastases were present in 45.6% of patients at initial diagnosis and almost 60% with tumors greater than 4 cm had metastases. CONCLUSIONS Renal carcinoid is the second most prevalent genitourinary carcinoid in each sex, following testicular carcinoids in men and ovarian tumors in women. Significant adverse prognostic factors include age greater than 40 years, tumor size greater than 4 cm, purely solid tumors on the cut surface, mitotic rate higher than 1/10 high power fields, metastasis at initial diagnosis and tumors extending throughout the renal capsule.
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Affiliation(s)
- Frederico R Romero
- James Buchanan Brady Urological Institute, The Johns Hopkins Medical Institutions, 600 North Wolfe Street, Baltimore, MD 21287, USA.
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45
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Murali R, Kneale K, Lalak N, Delprado W. Carcinoid tumors of the urinary tract and prostate. Arch Pathol Lab Med 2006; 130:1693-706. [PMID: 17076534 DOI: 10.5858/2006-130-1693-ctotut] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2006] [Indexed: 11/06/2022]
Abstract
CONTEXT Carcinoid tumors are exceedingly rare in the genitourinary tract and may occur in the kidney, urinary bladder, urethra, or prostate. OBJECTIVE To review the clinical and pathologic features of carcinoid tumors occurring in the urinary tract and prostate. DATA SOURCES We searched the English language literature using MEDLINE and Ovid. CONCLUSIONS Carcinoid tumors of the urinary tract and prostate share similar morphologic features with their counterparts in other organs. The differential diagnosis includes metastatic carcinoid tumor, paraganglioma, and nested variants of urothelial and prostatic carcinomas. Correlation of the clinical presentation and histopathologic features (including the immunohistochemical profile) will ensure accurate diagnosis of these rare tumors.
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Affiliation(s)
- Rajmohan Murali
- Department of Tissue Pathology, Institute of Clinical Pathology & Medical Research, Westmead Hospital, Sydney, Australia.
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46
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Rodríguez-Covarrubias F, Gómez X, Valerio JC, Lome-Maldonado C, Gabilondo F. Carcinoid tumor arising in a horseshoe kidney. Int Urol Nephrol 2006; 39:373-6. [PMID: 16835722 DOI: 10.1007/s11255-006-9031-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2006] [Accepted: 04/28/2006] [Indexed: 11/27/2022]
Abstract
Carcinoid tumors are common neoplasms developing in gastrointestinal and respiratory tract. They are rarely found in the kidney. To date, approximately 40 cases of primary renal carcinoid tumors have been reported, with less of a third of them occurring within a horseshoe kidney. These cases appear to have a better prognosis, even in the presence of distant metastases, compared to those arising in normal kidneys.
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Affiliation(s)
- Francisco Rodríguez-Covarrubias
- Department of Urology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Col Sección XVI, Tlalpan, Mexico City, Mexico.
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47
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Abstract
Most ureteral tumors are transitional cell neoplasms. Neuroendocrine tumors of the genitourinary tract are extremely rare. To our knowledge, only one ureteral carcinoid tumor has been reported before. We report a second case of ureteral carcinoid tumor found in a 70-year-old female.
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Affiliation(s)
- Te-An Lee
- Department of Urology, Hsinchu Mackay Memorial Hospital, Hsinchu, Taiwan.
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48
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Gross ML, Berger I. [Primary metastatic renal metastatic carcinoid tumor in a young male patient: a contribution to the differential diagnosis of neuroendocrine tumors]. DER PATHOLOGE 2006; 28:285-90. [PMID: 16645706 DOI: 10.1007/s00292-006-0831-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Primary renal carcinoid tumors originating in normal kidney are extremely rare. We report a case of primary renal carcinoid tumor with an aggressive clinical course and multiple metastases in the paraaortal lymph nodes and the liver as well as a pulmonary metastasis, in a 30-year-old patient. A CT scan of the abdomen revealed a large mass in the right kidney and multiple tumor suspect areas in the liver and paraaortal lymph nodes. The patient did not have clinical manifestations of carcinoid syndrome. Histologically, the tumor was composed of trabecular, solid or anastomosing ribbon-like nests, identical to the features of neuroendocrine tumors from other locations. Immunohistochemical staining was positive for cytokeratin, neurospecific enolase, and chromogranin. Electron microscopically, tonofibrils, primitive desmosomes, and dense-core granules with a neuroendocrine appearance were present. The pathological features of this case are briefly reviewed in comparison with those of previously reportet in terms of certain clinical aspects, prognostic factors and the WHO-classification (2004) of this rare neoplasia.
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Affiliation(s)
- M L Gross
- Institut für Pathologie, INF 220/221, 69120, Heidelberg
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49
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Lowrance WT, Chang SS, Herrell SD. Primary renal carcinoid tumor managed with laparoscopic partial nephrectomy. Urology 2006; 67:622.e19-20. [PMID: 16504256 DOI: 10.1016/j.urology.2005.09.042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2005] [Revised: 08/22/2005] [Accepted: 09/27/2005] [Indexed: 10/25/2022]
Abstract
Primary renal carcinoid is a rare tumor, with only 39 cases reported. These tumors have historically been managed with either open partial nephrectomy or open radical nephrectomy. We describe a patient with a primary renal carcinoid tumor successfully treated with laparoscopic partial nephrectomy. To our knowledge, this is the first such case reported.
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Affiliation(s)
- William T Lowrance
- Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee 37232-2765, USA.
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50
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Abstract
Primary renal carcinoid tumor is a rare tumor of the kidney. Less than 40 cases of primary and metastatic renal carcinoids have been reported. There is a strong association of renal carcinoid tumors with horseshoe kidneys [1, 2]. The radiographic appearance is non-specific and overlaps that of renal cell carcinoma. Histopathologic differentiation between these two entities is essential because the treatment and prognosis are entirely different. We report a unique case of multifocal carcinoid tumor within a horseshoe kidney with metastases to the thyroid gland. It has been postulated that the renal carcinoid horseshoe subtype carried a more favorable prognosis; however, our case with multifocal involvement and distant metastases suggests the possibility for a more aggressive course.
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