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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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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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3
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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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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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Hegemann M, Kroeger N, Stenzl A, Bedke J. Rare and changeable as a chameleon: paraneoplastic syndromes in renal cell carcinoma. World J Urol 2018; 36:849-854. [PMID: 29429069 DOI: 10.1007/s00345-018-2215-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 01/31/2018] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Paraneoplastic syndromes (PNS) in renal cell carcinoma (RCC) are important to be recognized by the treating physician, because they may lead to diagnosis of underlying malignant disease. On the other hand, PNS may dominate the clinical picture and can hide the true disorder like a chameleon. When realized, a PNS can be used as a 'neoplastic tumour marker', especially in case of recurrence. Their occurrence can even be linked to prognosis of disease. METHODS A PubMed search combining the MeSH terms renal cell carcinoma and paraneoplastic syndrome was executed in April 2015. All hits concerning these MeSH terms have been taken into account when writing this review. RESULTS There is a big gap between reporting and incidence of paraneoplastic syndromes in renal cell carcinoma. Most of the articles in Medline are case reports and reviews of research done in the 1950s-1990s. One problem is that a clear definition of a paraneoplastic syndrome is still lacking. The most important PNS in RCC are hypercalcemia. It is important that PNS are not only arising in advanced stages of renal cell carcinoma; in contrast, a PNS can often be the first symptom of RCC. CONCLUSION Paraneoplastic syndromes are often unrecognized but are important biomarkers in RCC. Further research into the underlying pathomechanisms of PNS may improve our understanding of the RCC tumour biology and is urgently needed.
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Affiliation(s)
- M Hegemann
- Department of Urology, Eberhard Karls University Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany
| | - N Kroeger
- Department of Urology, Ernst-Moritz-Arndt University Greifswald, Ferdinand Sauerbruch Str, 17475, Greifswald, Germany
| | - A Stenzl
- Department of Urology, Eberhard Karls University Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany
| | - J Bedke
- Department of Urology, Eberhard Karls University Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany.
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Successful Repeated Peptide Receptor Radionuclide Therapies in Renal Neuroendocrine Tumor With Osseous Metastasis. Clin Nucl Med 2017; 41:977-979. [PMID: 27749410 DOI: 10.1097/rlu.0000000000001386] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Renal neuroendocrine tumor (NET) is an extremely rarely occurring disease. The sporadic reports in the literature are mostly case reports, or less commonly small studies. In cases of metastatic disease from renal NET, there are no established therapies. We are reporting our experience with a patient with extensive osseous infiltration of a renal NET, who was successfully treated with peptide receptor radionuclide therapy (PRRT) using Lu-DOTATATE. In a period of 10 years, the patient underwent in total 12 cycles of PRRT with a cumulative dose of 81 GBq. All therapies were unproblematic and well tolerated.
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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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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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Lin C, Wu J, Gao Z, Qu G, Wang W, Yu G. Primary carcinoid tumor of the kidney with estrogen and progesterone receptor expression. Oncol Lett 2015; 10:449-452. [PMID: 26171049 DOI: 10.3892/ol.2015.3167] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2014] [Accepted: 04/09/2015] [Indexed: 01/17/2023] Open
Abstract
Primary carcinoid tumors are uncommon neoplasms in the kidney. The current study presents a case of primary carcinoid tumor of the kidney in a 49-year-old female who suffered from painless gross hematuria for half a month. Left hydronephrosis, a horseshoe kidney and a space-occupying lesion of the left ureter were found by abdominal computed tomography scans and ultrasonic testing. Surgery was performed and an oval tumor was found under the left ureter; the tumor and left kidney were excised completely. The neoplasm was composed of solid nests of cells, trabeculae, adenoid structures and anastomosing cords in a loose and myxoid background. The tumor cells, which were consistent in volume, exhibited centrally oval nuclei with inconspicuous nucleoli, and eosinophilic finely granular cytoplasm. Upon immunohistochemical staining, the neoplastic cells were positive for AE1/AE3, vimentin, synaptophysin, chromogranin A, estrogen receptor and progesterone receptor, while being negative for epithelial membrane antigen, inhibin A, cluster of differentiation (CD)99, S-100 and CD10. Based on the histological characteristics, a diagnosis of primary carcinoid tumor of the left kidney was formed. The patient did not receive further treatment. The total follow-up period was 18 months after the surgery and repeated imaging examinations every 6 months revealed no recurrence.
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Affiliation(s)
- Chunhua Lin
- Department of Surgery, Shandong University School of Medicine, Jinan, Shandong 250012, P.R. China ; Department of Urological Surgery, Affiliated Yantai Yuhuangding Hospital, Medical College of Qingdao University, Yantai, Shandong 264000, P.R. China
| | - Jitao Wu
- Department of Urological Surgery, Affiliated Yantai Yuhuangding Hospital, Medical College of Qingdao University, Yantai, Shandong 264000, P.R. China
| | - Zhenli Gao
- Department of Urological Surgery, Affiliated Yantai Yuhuangding Hospital, Medical College of Qingdao University, Yantai, Shandong 264000, P.R. China
| | - Guimei Qu
- Department of Pathology, Affiliated Yantai Yuhuangding Hospital, Medical College of Qingdao University, Yantai, Shandong 264000, P.R. China
| | - Wei Wang
- Department of Pathology, Affiliated Yantai Yuhuangding Hospital, Medical College of Qingdao University, Yantai, Shandong 264000, P.R. China
| | - Guohua Yu
- Department of Pathology, Affiliated Yantai Yuhuangding Hospital, Medical College of Qingdao University, Yantai, Shandong 264000, P.R. China
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11
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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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Ramkumar S, Dhingra A, Jyotsna VP, Ganie MA, Das CJ, Seth A, Sharma MC, Bal CS. Ectopic insulin secreting neuroendocrine tumor of kidney with recurrent hypoglycemia: a diagnostic dilemma. BMC Endocr Disord 2014; 14:36. [PMID: 24741994 PMCID: PMC4046058 DOI: 10.1186/1472-6823-14-36] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Accepted: 03/06/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hypoglycemia secondary to ectopic insulin secretion of non-pancreatic tumors is rare. CASE PRESENTATION We describe a middle aged woman with recurrent hypoglycemia. On evaluation, she was detected to have hyperinsulinemic hypoglycemia and right sided renal mass lesion. 68Ga-Dotanoc and 99mTc-HYNICTOC scans confirmed the intrarenal mass to be of neuroendocrine origin. Right nephrectomy was done and it turned out to be an insulin secreting neuroendocrine tumour. Neuroendocrine nature of this tumour was further confirmed by ultra-structural examination. Her hypoglycemia did not recur after resection of this tumour. CONCLUSION Few cases of ectopic insulin secretion have been reported though some are not proven convincingly. This case addresses all the issues raised in previous case reports and proves by clinical, laboratory, functional imaging and immunohistochemical analysis that ectopic origin of insulin by non-pancreatic tumors does occur. To our knowledge, this is the first reported case of ectopic insulinoma arising from the kidney.
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Affiliation(s)
- S Ramkumar
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
| | - Atul Dhingra
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
| | - VP Jyotsna
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
| | - Mohd Ashraf Ganie
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
| | - Chandan J Das
- Departments of Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - Amlesh Seth
- Departments of Urology, All India Institute of Medical Sciences, New Delhi, India
| | - Mehar C Sharma
- Departments of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Chandra Sekhar Bal
- Departments of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
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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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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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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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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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Walter T, Mege-Lechevallier F, Scoazec JY, Martin X, Chayvialle JA, Lombard-Bohas C. Well-differentiated endocrine carcinoma of the renal pelvis: report of a case with sustained objective response to octreotide. Pathol Res Pract 2008; 205:183-7. [PMID: 19041194 DOI: 10.1016/j.prp.2008.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2008] [Revised: 08/31/2008] [Accepted: 10/07/2008] [Indexed: 11/29/2022]
Abstract
Endocrine tumors of the upper urogenital tract are extremely rare. We report the case of a patient with a primary well-differentiated endocrine carcinoma of the renal pelvis metastatic to the liver, in whom an objective response was obtained under octreotide treatment. A 36-year-old woman without symptoms was admitted for exploration of a solid nodule in the right kidney. A right nephrectomy was performed. The histological examination of the surgical specimen diagnosed a primary well-differentiated endocrine tumor of the renal pelvis. Tumor cells strongly expressed synaptophysin and were focally positive for chromogranin A; they displayed faint reactivity for PSAP. Three months later, multiple liver metastases, proved by biopsy, were diagnosed. After two lines of chemotherapy, octreotide treatment was initiated because of persistent high activity at scintigraphic examination. A marked decrease in tumor volume and in chromogranin A serum levels was obtained. Two years later, there was no further progression. The patient was treated with octreotide. Our report points out the unusual immunophenotypic features which may be encountered in well-differentiated endocrine carcinoma of the upper urogenital tract and the potential interest in somatostatin analogues in the treatment of metastatic cases.
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Affiliation(s)
- Thomas Walter
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Fédération des Spécialités Digestives, 69437 Lyon cedex 03, France.
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Bhandari S, Watson N, Long E, Sharpe S, Zhong W, Xu SZ, Atkin SL. Expression of somatostatin and somatostatin receptor subtypes 1-5 in human normal and diseased kidney. J Histochem Cytochem 2008; 56:733-43. [PMID: 18443363 DOI: 10.1369/jhc.2008.950998] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Somatostatin mediates inhibitory functions through five G protein-coupled somatostatin receptors (sst1-5). We used immunohistochemistry, immunofluorescence, and RT-PCR to determine the presence of somatostatin receptors sst1, sst2A, sst2B, sst3, sst4, and sst5 in normal and IgA nephropathy human kidney. All somatostatin receptors were detected in the thin tubules (distal convoluted tubules and loops of Henle) and thick tubules (proximal convoluted tubules) in the tissue sections from nephrectomy and biopsy samples. Immunopositive sst1 and sst4 staining was more condensed in the cytoplasm of tubular epithelial cells. In normal kidney tissue sections, podocytes and mesangial cells in the glomeruli stained for sst1, sst2B, sst4 and sst5, and stained weakly for sst3. In IgA kidney tissue, the expression of somatostatin receptors was significantly increased with particular immmunopositive staining for sst1, sst2B, sst4, and sst5 within glomeruli. In the epithelial cells, the staining for sst2B and sst4 in proximal tubules and sst1, sst2B, and sst5 in distal tubules was increased. The mRNA expression of sst1-5 was also detected by RT-PCR. Somatostatin and all five receptor subtypes were ubiquitously distributed in normal kidney and IgA nephropathy. The increased expression of somatostatin receptors in IgA nephropathy kidney might be the potential pathogenesis of inflammatory renal disease.
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Affiliation(s)
- Sunil Bhandari
- Department of Renal Medicine, Hull Royal Infirmary, Hull and East Yorkshire Hospitals NHS Trust, Kingston-upon Hull, UK.
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Gedaly R, Jeon H, Johnston TD, McHugh PP, Rowland RG, Ranjan D. Surgical treatment of a rare primary renal carcinoid tumor with liver metastasis. World J Surg Oncol 2008; 6:41. [PMID: 18430248 PMCID: PMC2386474 DOI: 10.1186/1477-7819-6-41] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2008] [Accepted: 04/22/2008] [Indexed: 11/16/2022] Open
Abstract
Background Carcinoid tumors are characteristically low grade malignant neoplasms with neuroendocrine differentiation that arise in various body sites, most commonly the lung and gastrointestinal tract, but less frequently the kidneys, breasts, ovaries, testes, prostate and other locations. We report a case of a carcinoid of renal origin with synchronous single liver metastases on radiological studies. Case presentation A 45 year-old patient who presented with abdominal pain was found on CT scan to have lesions in the right ovary, right kidney, and left hepatic lobe. CA-125, CEA, and CA 19-9 were within normal limits, as were preoperative liver function tests and renal function. Biopsy of the liver mass demonstrated metastatic neuroendocrine tumor. At laparotomy, the patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy, radical right nephrectomy with lymphadenectomy, and left hepatectomy. Pathology evaluation reported a right ovarian borderline serous tumor, well-differentiated neuroendocrine carcinoma of the kidney (carcinoid) with 2 positive retroperitoneal lymph nodes, and a single liver metastasis. Immunohistochemistry revealed that this lesion was positive for synaptophysin and CD56, but negative for chromogranin as well as CD10, CD7, and CD20, consistent with a well-differentiated neuroendocrine tumor. She is doing well one year after her initial surgery, with no evidence of tumor recurrence. Conclusion Early surgical intervention, together with careful surveillance and follow-up, can achieve successful long-term outcomes in patients with this rare malignancy.
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Affiliation(s)
- Roberto Gedaly
- Division of Transplantation and Hepatobiliary Surgery, Department of Surgery, University of Kentucky Medical Center, Lexington, Kentucky, USA.
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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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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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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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Mufarrij P, Varkarakis IM, Studeman KD, Jarrett TW. Primary renal carcinoid tumor with liver metastases detected with somatostatin receptor imaging. Urology 2005; 65:1002. [PMID: 15882749 DOI: 10.1016/j.urology.2004.11.042] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2004] [Revised: 10/22/2004] [Accepted: 11/22/2004] [Indexed: 10/25/2022]
Abstract
If the final pathologic examination reveals a carcinoid tumor of the kidney, additional evaluation to rule out another occult primary tumor site is necessary. If the primary origin of the tumor is confirmed to be from the kidney, additional evaluation is required for the detection of metastasis. Renal carcinoid tumors are extremely rare; however, both primary and metastatic renal carcinoid tumors have been reported. We report a case of a 40-year-old woman with primary carcinoid of the kidney and metastatic disease in the liver not evident by computed tomography and magnetic resonance imaging but identified by somatostatin receptor scintigraphy.
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Affiliation(s)
- Patrick Mufarrij
- James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287-8915, USA
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Kim J, Suh K. Primary carcinoid tumor in a mature teratoma of the kidney: ultrasonographic and computed tomographic findings. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2004; 23:433-437. [PMID: 15055793 DOI: 10.7863/jum.2004.23.3.433] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Affiliation(s)
- Jongchul Kim
- Department of Diagnostic Radiology, College of Medicine, Chungnam National University, Daejeon, South Korea.
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Affiliation(s)
- J W Evans
- Department of Nuclear Medicine, Box 170, Addenbrooke' s Hospital, Hills Road, Cambridge CB2 2QQ, UK
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