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Sakr M, Badran M, Hassan SA, Elsaqa M, Elwany MA, Deeb NMFE, Sharafeldeen M. Detection of two synchronous histologically different renal cell carcinoma subtypes in the same kidney: a case report and review of the literature. J Med Case Rep 2024; 18:250. [PMID: 38760853 PMCID: PMC11102143 DOI: 10.1186/s13256-024-04527-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Accepted: 03/27/2024] [Indexed: 05/19/2024] Open
Abstract
INTRODUCTION Renal cell carcinoma (RCC) is the dominant primary renal malignant neoplasm, encompassing a significant portion of renal tumors. The presence of synchronous yet histologically distinct ipsilateral RCCs, however, is an exceptionally uncommon phenomenon that is rather under-described in the literature regarding etiology, diagnosis, management, and later outcomes during follow-up. CASE PRESENTATION We aim to present the 9th case of a combination chromophobe RCC (ChRCC) and clear cell RCC (ccRCC) in literature, according to our knowledge, for a 69-year-old North African, Caucasian female patient who, after complaining of loin pain and hematuria, was found to have two right renal masses with preoperative computed tomography (CT) and underwent right radical nephrectomy. Pathological examination later revealed the two renal masses to be of different histologic subtypes. CONCLUSION The coexistence of dissimilar RCC subtypes can contribute to diverse prognostic implications. Further research should focus on enhancing the complex, yet highly crucial, preoperative detection and pathological examination to differentiate multiple renal lesions. Planning optimal operative techniques (radical or partial nephrectomy), selecting suitable adjuvant regimens, and reporting long-term follow-up outcomes of patients in whom synchronous yet different RCC subtypes were detected are of utmost importance.
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Affiliation(s)
- Mohamed Sakr
- Faculty of Medicine, Alexandria University, Champollion Street, Alexandria, Egypt
| | - Merhan Badran
- Faculty of Medicine, Alexandria University, Champollion Street, Alexandria, Egypt.
| | - Sarah Ahmed Hassan
- Faculty of Medicine, Alexandria University, Champollion Street, Alexandria, Egypt
| | - Mohamed Elsaqa
- Faculty of Medicine, Alexandria University, Champollion Street, Alexandria, Egypt
| | - Mohamed Anwar Elwany
- Faculty of Medicine, Alexandria University, Champollion Street, Alexandria, Egypt
| | - Nevine M F El Deeb
- Faculty of Medicine, Alexandria University, Champollion Street, Alexandria, Egypt
| | - Mohamed Sharafeldeen
- Faculty of Medicine, Alexandria University, Champollion Street, Alexandria, Egypt
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Clark DJ, Zhang H. Proteomic approaches for characterizing renal cell carcinoma. Clin Proteomics 2020; 17:28. [PMID: 32742246 PMCID: PMC7391522 DOI: 10.1186/s12014-020-09291-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 05/15/2020] [Indexed: 12/24/2022] Open
Abstract
Renal cell carcinoma is among the top 15 most commonly diagnosed cancers worldwide, comprising multiple sub-histologies with distinct genomic, proteomic, and clinicopathological features. Proteomic methodologies enable the detection and quantitation of protein profiles associated with the disease state and have been explored to delineate the dysregulated cellular processes associated with renal cell carcinoma. In this review we highlight the reports that employed proteomic technologies to characterize tissue, blood, and urine samples obtained from renal cell carcinoma patients. We describe the proteomic approaches utilized and relate the results of studies in the larger context of renal cell carcinoma biology. Moreover, we discuss some unmet clinical needs and how emerging proteomic approaches can seek to address them. There has been significant progress to characterize the molecular features of renal cell carcinoma; however, despite the large-scale studies that have characterized the genomic and transcriptomic profiles, curative treatments are still elusive. Proteomics facilitates a direct evaluation of the functional modules that drive pathobiology, and the resulting protein profiles would have applications in diagnostics, patient stratification, and identification of novel therapeutic interventions.
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Affiliation(s)
- David J. Clark
- Department of Pathology, The Johns Hopkins University, Baltimore, MD 21231 USA
| | - Hui Zhang
- Department of Pathology, The Johns Hopkins University, Baltimore, MD 21231 USA
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A Composite Renal Tumor with Dual Differentiation, Chromophobe and Collecting Duct Carcinoma. Case Rep Pathol 2018; 2018:2410920. [PMID: 30228921 PMCID: PMC6136464 DOI: 10.1155/2018/2410920] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 08/08/2018] [Indexed: 11/17/2022] Open
Abstract
Chromophobe carcinoma constitutes a small subset of all renal carcinomas. Within this category, rare tumors with divergent differentiation have been recognized. Herein, we report a rare case of composite chromophobe and collecting duct carcinoma and describe its pathologic and clinical features.
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Arık D, Açıkalın MF, Can C. Papillary renal cell carcinoma and collecting duct carcinoma combination. A case report and review of synchronous renal cell carcinoma subtypes in the same kidney. Arch Med Sci 2015; 11:686-90. [PMID: 26170866 PMCID: PMC4495165 DOI: 10.5114/aoms.2015.52378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Revised: 02/12/2014] [Accepted: 02/18/2014] [Indexed: 11/18/2022] Open
Affiliation(s)
- Deniz Arık
- Department of Pathology, Faculty of Medicine, Eskisehir Osmangazi University, Eskişehir, Turkey
| | - Mustafa Fuat Açıkalın
- Department of Pathology, Faculty of Medicine, Eskisehir Osmangazi University, Eskişehir, Turkey
| | - Cavit Can
- Department of Urology, Faculty of Medicine, Eskisehir Osmangazi University, Eskişehir, Turkey
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López JI, Larrinaga G, Kuroda N, Angulo JC. The normal and pathologic renal medulla: A comprehensive overview. Pathol Res Pract 2015; 211:271-80. [DOI: 10.1016/j.prp.2014.12.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 11/26/2014] [Accepted: 12/09/2014] [Indexed: 01/13/2023]
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Picken MM. The Evolving Concept of Renal Neoplasia: Impact of Emerging Molecular and Electron Microscopic Studies. Ultrastruct Pathol 2009; 29:277-82. [PMID: 16036881 DOI: 10.1080/01913120590951266] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The classification of renal tumors has evolved from one that initially encompassed only 2 types of tumors, i.e., clear and granular cell carcinomas, to the markedly expanded recent classification that incorporates new entities, some of which are primarily defined by specific molecular abnormalities. Despite these advances, a single tumor category, clear cell carcinoma, still incorporates the majority (approximately 70%) of renal tumors. It is, however, postulated that this single category is likely to encompass several different tumor types that are, at present, undifferentiated. Electron microscopic studies have been pivotal in defining the spectrum of oncocytoma-chromophobe renal cell carcinoma. Cytoplasmic eosinophilia found in some renal cell carcinomas currently classified as clear cell type is under intense study. Tumors that have recently emerged from this group include tumors with translocations involving chromosome Xp11.2, carcinomas associated with neuroblastoma and epithelioid angiomyolipoma. The spectrum of renal tumors seen in younger patients is wider than among older patients, with rare and unusual tumors being more likely seen in younger patients. The author concludes that although the routine application of electron microscopy to kidney tumor diagnosis may not be practical, systematic ultrastructural studies of these tumors may aid in the definition of new entities.
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Affiliation(s)
- Maria M Picken
- Department of Pathology, Loyola University Medical Center, Chicago, Illinois 60153, USA.
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Chromosome 1 analysis in chromophobe renal cell carcinomas with tissue microarray (TMA)-facilitated fluorescence in situ hybridization (FISH) demonstrates loss of 1p/1 which is also present in renal oncocytomas. ACTA ACUST UNITED AC 2008; 17:141-4. [PMID: 18382368 DOI: 10.1097/pdm.0b013e3181577d57] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Morphologic overlap between chromophobe renal cell carcinoma (ChRCC) and renal oncocytomas (RO) has been widely recognized. Whether these tumors are genetically related and represent a spectrum of benign to malignant tumor progression remains an open question. We previously showed by conventional cytogenetics and fluorescent in situ hybridization (FISH) that the most common chromosomal abnormality in RO is loss of chromosome 1 or 1p. In this study, we evaluated chromosome 1 in ChRCC using the same set of FISH probes. Twenty-one ChRCCs from 13 men and 8 women were studied. Formalin-fixed, paraffin-embedded tissue blocks were used to construct tissue microarrays. A subtelomeric 1p36.3 probe was used in tandem with 1q25 probes for FISH studies. The patients ranged in age from 34 to 82 years (mean 62.8 y, median 61 y). FISH analysis showed an abnormal chromosome 1 in 20/21 (95%) ChRCCs as follows: 18 tumors (85%) had loss of entire chromosome 1, 2 tumors (10%) had loss of 1p36.3 only, and 1 tumor (5%) was apparently diploid for chromosome 1. In this study, 95% of ChRCCs showed abnormality of chromosome 1 by FISH. The progression of chromosome 1 abnormalities, from diploid to loss of 1p to loss of entire chromosome, is also present in oncocytomas. These results provide further evidence to support a genetic similarity between chromophobe carcinoma and oncocytoma. Whether abnormalities of chromosome 1 are associated with RO tumorigenesis or its progression to carcinoma requires further studies.
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The importance of histology and cytogenetics in decision making for renal cell carcinoma. World J Urol 2008; 26:155-60. [DOI: 10.1007/s00345-008-0262-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2008] [Accepted: 03/24/2008] [Indexed: 10/22/2022] Open
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Algaba F, Arce Y, Trias I, Santaularia JM, Antonio Rosales A. Aplicación clínica de las actuales clasificaciones del cáncer renal. Actas Urol Esp 2006; 30:372-85. [PMID: 16838609 DOI: 10.1016/s0210-4806(06)73461-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The purpose of classifying neoplasias is to recognize groups with similar progress and prognosis and, if possible, receiving the same treatment. This is why those classifications are systematically being submitted to review and improvement through the new technologies. Differentiation of various entities in renal cancer has been comparatively fast, as the new genetic and molecular discoveries have confirmed the morphologic criteria of the different cell types, thus making it possible to open new therapeutic pathways. Using the current WHO classification we recognize subtypes with excellent prognosis (Multilocular cystic renal carcinoma, Type I renal papillary carcinoma, Tubular and fusocellular mucinous carcinoma), other very aggressive ones (Bellini's collecting duct carcinoma, Medullary carcinoma), and also that the sarcomatoid transformation, even in small areas, impacts the prognosis negatively. Childhood-characteristic renal carcinomas associated with chromosome translocations have been recognized (genetic fusion TFE3 or TFEB), as well as the family forms of renal carcinoma. Regarding the UICC (International Union Against Cancer) classification, there are a series of aspects under argument (size, venous invasion, microvascular invasion, invasion of the adipous tissue of the renal sinus) that shall be discussed too, since it is possible that some modifications of the TNM might occur in the near future.
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MESH Headings
- Adenocarcinoma, Mucinous/epidemiology
- Adenocarcinoma, Mucinous/genetics
- Adenocarcinoma, Mucinous/pathology
- Adolescent
- Adult
- Biomarkers, Tumor/analysis
- Carcinoma/chemistry
- Carcinoma/classification
- Carcinoma/epidemiology
- Carcinoma/genetics
- Carcinoma/pathology
- Carcinoma, Papillary/chemistry
- Carcinoma, Papillary/epidemiology
- Carcinoma, Papillary/genetics
- Carcinoma, Papillary/pathology
- Carcinoma, Renal Cell/classification
- Carcinoma, Renal Cell/epidemiology
- Carcinoma, Renal Cell/pathology
- Cell Differentiation
- Cell Nucleus/ultrastructure
- Child
- Chromosomes, Human/genetics
- Chromosomes, Human/ultrastructure
- Female
- Humans
- Kidney Neoplasms/chemistry
- Kidney Neoplasms/classification
- Kidney Neoplasms/epidemiology
- Kidney Neoplasms/genetics
- Kidney Neoplasms/pathology
- Kidney Tubules, Collecting/pathology
- Male
- Neoplasm Proteins/analysis
- Neoplasms, Germ Cell and Embryonal/classification
- Neoplasms, Germ Cell and Embryonal/pathology
- Neoplastic Syndromes, Hereditary/genetics
- Prognosis
- Translocation, Genetic
- World Health Organization
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Affiliation(s)
- F Algaba
- Sección de Patologia, Fundació Puigvert-Barcelona.
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Kawano N, Inayama Y, Nakaigawa N, Yao M, Ogawa T, Aoki I, Kitamura H, Nakatani Y, Nagashima Y. Composite distal nephron-derived renal cell carcinoma with chromophobe and collecting duct carcinomatous elements. Pathol Int 2005; 55:360-5. [PMID: 15943794 DOI: 10.1111/j.1440-1827.2005.01837.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Chromophobe renal cell carcinoma (RCC) and collecting duct carcinoma (CDC) are derived from the collecting duct epithelia, although their morphology, molecular biologic characteristics and clinical behaviors are quite different. Herein is presented a case of RCC possessing the chromophobe RCC and CDC elements occurring in a 64 year-old Japanese woman. The patient was referred to Yokohama City University Hospital with complaints of persistent back pain and fever. Radiologic examinations revealed a left renal tumor, and radical nephrectomy was performed. The patient died with multiple metastases, 8 months after the operation. The resected tumor showed an invasive growth, and its cut surface was heterogenous with hemorrhage and necrosis. Histologically, the tumor was composed of chromophobe elements with dedifferentiation, and CDC elements. The chromophobe and CDC elements had obvious histological transition. Lectin histochemistry and immunohistochemistry confirmed that this tumor was derived from the distal nephron. c-KIT, p53 and Ki67 antigen showed differential localization between the chromophobe and CDC elements, even in the transitional areas. Along with the previous reports, the present case seemed to be composite RCC derived from the collecting duct, which might present clues to elucidate carcinogenesis in the distal nephron.
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Affiliation(s)
- Naomi Kawano
- Division of Anatomical and Surgical Pathology, Yokohama City University Hospital, Yokohama, Japan
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