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Bersanelli M, Rebuzzi SE, Roviello G, Catalano M, Brunelli M, Rizzo M. Immune checkpoint inhibitors in non-conventional histologies of renal-cell carcinoma. Hum Vaccin Immunother 2023; 19:2171672. [PMID: 36758960 PMCID: PMC10012923 DOI: 10.1080/21645515.2023.2171672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
For years, prospective randomized clinical trials excluded patients with non-conventional histologies of renal cell carcinoma (RCC). The paucity of data has led to adopting the same treatment strategies used for clear-cell RCC (ccRCC). In the present narrative review, we explored state of the art about use of immune checkpoint inhibitors (ICIs) in variant histologies of RCC. According to the results collected, ICIs as monotherapy showed promising antitumor activity in advanced non-clear cell (ncc)RCC. The objective response rate (ORR) was similar to that observed with single-agent anti-PD-1 in the ccRCC population, either in the first-line or the second-line setting, and responder patients experienced an early and durable benefit. Combined ICI-based strategies have shown increasing evidence in nccRCC and robust results in the sarcomatoid variants of RCC. A definitive recommendation about treating non-conventional histologies, either in adjuvant or metastatic settings, should be supported by more extensive dedicated trials.
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Affiliation(s)
| | - Sara Elena Rebuzzi
- Medical Oncology Unit, Ospedale San Paolo, Savona, Italy.,Department of Internal Medicine and Medical Specialties (Di.M.I.), University of Genoa, Genoa, Italy
| | | | - Martina Catalano
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Matteo Brunelli
- Department of Pathology, Azienda Ospedaliera Universitaria Integrata Verona, University of Verona, Verona, Italy
| | - Mimma Rizzo
- Medical Oncology Unit, Azienda Ospedaliero Universitaria Consorziale Policlinico di Bari, Bari, Italy
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Tang C, Dong J, Chen H, Li P, Zhou Y, He H, Sheng Z, Qu L, Zhou W. Collecting Duct Carcinoma of the Kidney: A Single-Center Retrospective Study of 23 Cases. Technol Cancer Res Treat 2023; 22:15330338231165141. [PMID: 36942462 PMCID: PMC10034286 DOI: 10.1177/15330338231165141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023] Open
Abstract
Objective: To explore the clinical, imaging, pathologic features, treatment, and prognostic outcomes in 23 cases of collecting duct carcinoma (CDC) from a single center. Methods: The clinical and imaging findings, pathological features, treatment methods, and outcomes of the 23 patients with CDC confirmed by microscopic examination between 2003 and 2020 at our institution were retrospectively reviewed. Descriptive statistics of demographic and clinical variables were applied. Kaplan-Meier method was used to analyze survival data and log-rank test statistic survival differences between groups. Cox regression analysis was employed to identify variables independently related to overall survival (OS). Results: A total of 23 patients with CDC were identified. The mean age was 50.8 years. Stage III or IV tumors were diagnosed in 82.6% of the patients at diagnosis. The average size of the tumor was 6.58 cm, and the left kidney was more involved than the right. The median OS was 12 months. The OS rates at 1 and 2 years were 43.5% and 26.1%, respectively. Twenty patients underwent nephrectomy, 3 underwent nephroureterectomy, and 9 (39.1%) patients received subsequent therapeutic interventions following surgery. Distant metastasis and no symptoms at initial diagnosis proved to be an independent factor of unfavorable survival in Cox regression analysis. Conclusions: CDC is a rare and highly aggressive malignant renal tumor, and most patients present at an advanced stage at initial diagnosis. More than half of the patients died within 1 year after surgery. Distant metastasis and no clinical symptoms at initial diagnosis were independent risk prognostic factors for patients with CDC.
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Affiliation(s)
- Chaopeng Tang
- Department of Urology, Jinling Hospital, Jinling School of Clinical Medicine, 12461Nanjing Medical University, Nanjing, China
| | - Jie Dong
- Department of Urology, Jinling Hospital, Jinling School of Clinical Medicine, 12461Nanjing Medical University, Nanjing, China
| | - Hui Chen
- Department of Pathology, Jinling Hospital, Jinling School of Clinical Medicine, 12461Nanjing Medical University, Nanjing, China
| | - Ping Li
- Department of Urology, Jinling Hospital, Jinling School of Clinical Medicine, 12461Nanjing Medical University, Nanjing, China
| | - Yulin Zhou
- Department of Urology, Jinling Hospital, Jinling School of Clinical Medicine, 12461Nanjing Medical University, Nanjing, China
| | - Haowei He
- Department of Urology, Jinling Hospital, Jinling School of Clinical Medicine, 12461Nanjing Medical University, Nanjing, China
| | - Zhengcheng Sheng
- Department of Urology, Jinling Hospital, Jinling School of Clinical Medicine, 12461Nanjing Medical University, Nanjing, China
| | - Le Qu
- Department of Urology, Jinling Hospital, Jinling School of Clinical Medicine, 12461Nanjing Medical University, Nanjing, China
| | - Wenquan Zhou
- Department of Urology, Jinling Hospital, Jinling School of Clinical Medicine, 12461Nanjing Medical University, Nanjing, China
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3
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Liu Q, Li G, Yang Z, Cheng Y, Kong X, Jiang R. Extra-Kidney Mass. Urology 2022; 170:e1-e2. [PMID: 36195165 DOI: 10.1016/j.urology.2022.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 09/13/2022] [Accepted: 09/18/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Qinwen Liu
- Department of Urology, the Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, China; Nephropathy Clinical Medical Research Center of Sichuan Province, China
| | - Ge Li
- Department of Urology, the Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, China; Nephropathy Clinical Medical Research Center of Sichuan Province, China
| | - Zhihui Yang
- Department of pathology, the Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, China
| | - Yong Cheng
- Department of Urology, the Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, China; Nephropathy Clinical Medical Research Center of Sichuan Province, China
| | - Xiangjun Kong
- Department of Urology, the Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, China; Nephropathy Clinical Medical Research Center of Sichuan Province, China
| | - Rui Jiang
- Department of Urology, the Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, China; Nephropathy Clinical Medical Research Center of Sichuan Province, China.
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4
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Guillaume Z, Colomba E, Thouvenin J, Saldana C, Campedel L, Dumont C, Laguerre B, Maillet D, Vicier C, Rolland F, Borchiellini D, Barthelemy P, Albiges L, Auclin E, Roulleaux Dugage M, Oudard S, Thibault C. Metastatic Renal Medullary and Collecting Duct Carcinoma in the Era of Antiangiogenic and Immune Checkpoint Inhibitors: A Multicentric Retrospective Study. Cancers (Basel) 2022; 14. [PMID: 35406448 DOI: 10.3390/cancers14071678] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 03/18/2022] [Accepted: 03/21/2022] [Indexed: 12/07/2022] Open
Abstract
Collecting duct carcinoma (CDC) and renal medullary carcinoma (RMC) are two rare subtypes of kidney cancer with a poor prognosis in the metastatic setting. Beyond first-line treatment, there are no standard-of-care therapies. This retrospective study assessed the efficacy of treatments after first-line chemotherapy in 57 patients with metastatic (m) CDC (n = 35) or RMC (n = 22) treated between 2010 and 2019 at 11 French centers. The median age was 53 years; overall, 60% (n = 34) of patients were metastatic at diagnosis. After a median follow-up of 13 months, the median overall survival was 12 (95% CI, 11−16) months. All patients received first-line platinum chemotherapy ± bevacizumab, with a median time to progression of 7.27 (95% CI, 7−100 months and an objective response rate (ORR) of 39% (95% CI, 26−52%). Patients received a median of two (1−5) treatment lines. Subsequent treatments included tyrosine kinase inhibitors (n = 12), chemotherapy (n = 34), and checkpoint inhibitors (n = 20), with ORR ranging 10−15% and disease control rates ranging 24−50%. The duration of response for all treatments was ~2 months. Notably, nine patients with CDC were still alive > two years after metastatic diagnosis. Beyond first-line therapy, treatments showed very low antitumor activity in mCDC/RMC. A better understanding of the biology of those rare tumors is urgently needed in order to identify potential targets.
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Tosh JM, Navriya SC, Kumar S, Singh S, Ramachandra D, Khandari A. Surgical management of renal cell carcinoma invading the liver - a case report and systematic review. Pol Przegl Chir 2022; 94:37-44. [PMID: 36047362 DOI: 10.5604/01.3001.0015.7678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
<b>Introduction:</b> Renal cell cancer (RCC) is one of the most lethal malignancies, accounting for 2.2% of all cancer diagnoses [1] </br></br> <b> Aim:</b> This study aims to perform the first systematic review of the operative techniques of simultaneous radical nephrectomy with hepatic resection for renal cell carcinoma (RCC) with direct hepatic extension. We also report a case of collecting duct RCC invading the liver who underwent simultaneous nephrectomy with hepatic resection. </br></br> <b>Materials and methods:</b> We searched the articles between the years 1991 and 1st April 2021 in English in PubMed, EMBASE, and Scopus databases. Case reports, case series, and matched cohort studies were included. Eligible studies reported on renal mass characteristics with the nature of extension, histopathological features, operative manoeuvres, and outcomes.Data were extracted as per Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. </br></br> <b>Results:</b> The initial search strategy yielded 148 articles of which six articles were selected for review. The mean size of tumour was >10 cm, with the mean age of the patients being 51-67 years. All cases had RCC with direct extension to the liver, and all underwent simultaneous nephrectomy with liver resection. The most common histological type was clear cell carcinoma. The mean blood loss was 3.3 litres, and the mean hospital stay was 9.75 days. </br></br> <b>Conclusion:</b> This review shows that the invasion to surrounding structures, including the liver, by RCC is not so common, and it poses a treatment challenge for the clinician. Currently, en bloc surgical removal with anatomical or non-anatomical resection of the liver is the only modality that provides the best chance of control for the RCC with direct hepatic extension.
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Affiliation(s)
| | | | - Sunil Kumar
- Department of Urology,AIIMS, Rishikesh, India
| | | | - Deepti Ramachandra
- Department of Gastro-Surgery, All India Institute of Medical Sciences, Rishikesh, India
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Wei L, Huang Y, Chen Z, Li J, Huang G, Qin X, Cui L, Zhuo Y. A Novel Machine Learning Algorithm Combined With Multivariate Analysis for the Prognosis of Renal Collecting Duct Carcinoma. Front Oncol 2022; 11:777735. [PMID: 35096579 PMCID: PMC8792389 DOI: 10.3389/fonc.2021.777735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 12/21/2021] [Indexed: 11/29/2022] Open
Abstract
Objectives To investigate the clinical and non-clinical characteristics that may affect the prognosis of patients with renal collecting duct carcinoma (CDC) and to develop an accurate prognostic model for this disease. Methods The characteristics of 215 CDC patients were obtained from the U.S. National Cancer Institute’s surveillance, epidemiology and end results database from 2004 to 2016. Univariate Cox proportional hazard model and Kaplan-Meier analysis were used to compare the impact of different factors on overall survival (OS). 10 variables were included to establish a machine learning (ML) model. Model performance was evaluated by the receiver operating characteristic curves (ROC) and calibration plots for predictive accuracy and decision curve analysis (DCA) were obtained to estimate its clinical benefits. Results The median follow-up and survival time was 16 months during which 164 (76.3%) patients died. 4.2, 32.1, 50.7 and 13.0% of patients were histological grade I, II, III, and IV, respectively. At diagnosis up to 61.9% of patients presented with a pT3 stage or higher tumor, and 36.7% of CDC patients had metastatic disease. 10 most clinical and non-clinical factors including M stage, tumor size, T stage, histological grade, N stage, radiotherapy, chemotherapy, age at diagnosis, surgery and the geographical region where the care delivered was either purchased or referred and these were allocated 95, 82, 78, 72, 49, 38, 36, 35, 28 and 21 points, respectively. The points were calculated by the XGBoost according to their importance. The XGBoost models showed the best predictive performance compared with other algorithms. DCA showed our models could be used to support clinical decisions in 1-3-year OS models. Conclusions Our ML models had the highest predictive accuracy and net benefits, which may potentially help clinicians to make clinical decisions and follow-up strategies for patients with CDC. Larger studies are needed to better understand this aggressive tumor.
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Affiliation(s)
- Liwei Wei
- Department of Urology, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Yongdi Huang
- College of Mathematics and Physics, Beijing University of Chemical Technology, Beijing, China
| | - Zheng Chen
- Department of Urology, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Jinhua Li
- Department of Urology, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Guangyi Huang
- Department of Urology, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Xiaoping Qin
- Department of Urology, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Lihong Cui
- College of Mathematics and Physics, Beijing University of Chemical Technology, Beijing, China
| | - Yumin Zhuo
- Department of Urology, The First Affiliated Hospital of Jinan University, Guangzhou, China
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7
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An J, Packiam VT, Chennamadhavuni A, Richards J, Jain J, Mott SL, Garje R. Patient Characteristics and Survival Outcomes of Non-Metastatic, Non-Clear Cell Renal Cell Carcinoma. Front Oncol 2022; 11:786307. [PMID: 35083144 PMCID: PMC8786111 DOI: 10.3389/fonc.2021.786307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/09/2021] [Indexed: 11/17/2022] Open
Abstract
Background Non-clear cell renal cell carcinoma (ccRCC) includes histologically and molecularly distinct subtypes such as papillary, chromophobe, collecting duct, and sarcomatoid RCC, with an incidence ranging from 20% to 25%. Oncologic outcomes and the role of adjuvant systemic therapy [vascular endothelial growth factor inhibitor (VEGFi) or immunotherapy] for non-ccRCC are not well-described. Objective To assess the incidence and survival outcomes of non-ccRCC subtypes in comparison to ccRCC. Methods The National Cancer Database was utilized to identify patients with non-metastatic RCC (T1–T4, N0–N1) between 2004 and 2015. The non-ccRCC cohort was further stratified by histologic subtype: papillary, chromophobe, sarcomatoid, and collecting duct RCC. Multivariable Cox regression models were used to compare overall survival (OS). Results The 5-year OS for chromophobe, papillary, clear cell, collecting duct, and sarcomatoid RCC was 91%, 82%, 81%, 44%, and 40%, respectively. After adjusting for clinicopathologic and treatment characteristics, there was no significant difference in OS between papillary RCC and ccRCC (p = 0.17). Patients with collecting duct and sarcomatoid subtypes were at over two times increased risk of death compared to patients with clear cell (p < 0.01 and p < 0.01, respectively). Conversely, patients with chromophobe RCC were at 36% decreased risk of death compared to ccRCC (p < 0.01). Conclusions This hospital-based analysis confirms that collecting duct and sarcomatoid histologic subtypes are uncommon and associated with poor survival after surgery when compared to the other RCC subtypes. Further studies are needed to evaluate the role of neoadjuvant and adjuvant systemic therapies in these subtypes to improve oncologic outcomes.
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Affiliation(s)
- Josiah An
- Division of Hematology, Oncology, Blood & Marrow Transplantation, Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
| | - Vignesh T Packiam
- Department of Urology, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
| | - Adithya Chennamadhavuni
- Division of Hematology, Oncology, Blood & Marrow Transplantation, Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
| | - Jordan Richards
- Department of Urology, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
| | - Jayanshu Jain
- Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
| | - Sarah L Mott
- Holden Comprehensive Cancer Center, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
| | - Rohan Garje
- Division of Hematology, Oncology, Blood & Marrow Transplantation, Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
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Zhou W, Huang J, He Q, Luo Q, Zhang X, Tao X, Dong H, Tu X. Persistent Response to a Combination Treatment Featuring a Targeted Agent and an Immune Checkpoint Inhibitor in a Patient With Collecting Duct Renal Carcinoma: A Case Report and Literature Review. Front Oncol 2021; 11:764352. [PMID: 34820330 PMCID: PMC8606665 DOI: 10.3389/fonc.2021.764352] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 10/25/2021] [Indexed: 01/10/2023] Open
Abstract
Collecting duct carcinoma (CDC) is a rare and highly aggressive subtype of kidney cancer that is associated with a poor prognosis. At present, there is no effective treatment for CDC. Herein, we report a case of metastatic CDC treated with a combination of a tyrosine kinase inhibitor and an immune checkpoint inhibitor. A 67-year-old male was diagnosed with CDC with lung and bone metastasis. Pazopanib and camrelizumab were administered after cytoreductive nephrectomy. The patient achieved a partial response after one cycle of treatment; however, he then experienced serious drug-induced hepatic injury. Therefore, we discontinued camrelizumab and administered monotherapy with pazopanib. Three months later, the cancer had progressed and axitinib and sintilimab were administered. The patient achieved a partial response, accompanied by the complete disappearance of the metastatic lesion in the lung. The patient had an excellent physical status after 11 months. This is the first reported case of metastatic CDC successfully treated with a combination of a tyrosine kinase inhibitor and an immune checkpoint inhibitor. This form of combination treatment may be an effective option for treating metastatic CDC.
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Affiliation(s)
- Weimin Zhou
- Department of Urology, Jiangxi Cancer Hospital of Nanchang University, Jiangxi Cancer Center, Nanchang, China
| | - Ji Huang
- Department of Urology, Jiangxi Cancer Hospital of Nanchang University, Jiangxi Cancer Center, Nanchang, China
| | - Qiuming He
- Department of Urology, Jiangxi Cancer Hospital of Nanchang University, Jiangxi Cancer Center, Nanchang, China
| | - Qingfeng Luo
- Department of Pathology, Jiangxi Cancer Hospital of Nanchang University, Jiangxi Cancer Center, Nanchang, China
| | - Xiaofang Zhang
- Department of Pathology, Jiangxi Cancer Hospital of Nanchang University, Jiangxi Cancer Center, Nanchang, China
| | - Xuewei Tao
- Department of Radiology, Jiangxi Cancer Hospital of Nanchang University, Jiangxi Cancer Center, Nanchang, China
| | - Hanzhi Dong
- Department of Internal Medical Oncology, Jiangxi Cancer Hospital of Nanchang University, Jiangxi Cancer Center, Nanchang, China
| | - Xinhua Tu
- Department of Urology, Jiangxi Cancer Hospital of Nanchang University, Jiangxi Cancer Center, Nanchang, China
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9
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Tang C, Zhou Y, Ge S, Yi X, Lv H, Zhou W. Incidence, Clinical Characteristics, and Survival of Collecting Duct Carcinoma of the Kidney: A Population-Based Study. Front Oncol 2021; 11:727222. [PMID: 34595117 PMCID: PMC8476990 DOI: 10.3389/fonc.2021.727222] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 08/25/2021] [Indexed: 11/29/2022] Open
Abstract
Objective To investigate the exact age‐adjusted incidence (AAI), clinical characteristics, and survival data of collecting duct carcinoma of the kidney (CDCK) recorded in the Surveillance, Epidemiology, and End Results (SEER) database of the National Cancer Institute. Methods Patients with CDCK confirmed by microscopic examination from 2004 to 2018 were selected from the SEER database. AAI rates were calculated using SEER*Stat software (version 8.3.9). The Kaplan‐Meier method was used to evaluate cancer-specific survival (CSS) rates according to tumor size, tumor stage, and treatment methods, and differences among these variables were assessed by the log‐rank test. Cox regression analysis was employed to identify variables independently related to CSS. Results A total of 286 patients with CDCK were identified from the database. The majority of the patients were white (69.2%), male (67.5%), and married (60.5%), and the median age was 59 years. Most patients with CDCK (74.4%) presented with stages III or IV disease. The diameter of most (59.4%) tumors was less than 7 cm, and the tumors were more commonly found on the left than on the right (55.2% vs. 44.8%). The incidence of CDCK decreased over time. The median CSS time was 17 months. In terms of the treatment modalities used, 83.9% of the patients underwent surgery; 32.9% underwent chemotherapy, and 13.6% underwent radiotherapy. The CSS rates at 1, 2, and 5 years were 57.3%, 43.2%, and 30.7%, respectively. In patients with stage IV CDCK treated with surgery alone, chemotherapy alone, and surgery plus chemotherapy, the median survival time was 5 months, 9 months, and 14 months, respectively (P =0.024). Multivariate Cox regression analysis showed surgery, chemotherapy, stage, regional lymph node metastasis, and distant metastasis were independent prognostic factors for patients with CDCK. Conclusions CDCK is an uncommon malignant renal carcinoma, and its incidence is decreasing based on the analysis of current data. CDCK is a high stage, regional lymph-nodes positive, and metastatic disease. Compared with surgery alone or chemotherapy alone, patients with stage IV could gain survival benefit from surgery combined with chemotherapy.
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Affiliation(s)
- Chaopeng Tang
- Department of Urology, Jinling Hospital, Jinling School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Yulin Zhou
- Department of Urology, Jinling Hospital, Jinling School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Silun Ge
- Department of Urology, Jinling Hospital, Jinling School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Xiaoming Yi
- Department of Urology, Jinling Hospital, Jinling School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Huichen Lv
- Department of Urology, Jinling Hospital, Jinling School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Wenquan Zhou
- Department of Urology, Jinling Hospital, Jinling School of Clinical Medicine, Nanjing Medical University, Nanjing, China
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Carreira V, Standeven AM, Ma JY, Hardisty J, Cohen SM, Kerns WD, Snook S. Inhibitors of TGFβR1/ALK4/JNK3/Flt1 Kinases in Cynomolgus Macaques Lead to the Rapid Induction of Renal Epithelial Tumors. Toxicol Sci 2021; 180:51-61. [PMID: 33483736 DOI: 10.1093/toxsci/kfaa190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Two young cynomolgus macaques (Macaca fascicularis) given a small molecule kinase inhibitor ((S)-4-((2-(5-chloro-2-fluorophenyl)-5-isopropylpyrimidin-4-yl)amino)-N-(2-hydroxypropyl)nicotinamide [SCIO-120]) via nasogastric intubation gavage, once-daily for 21 days at 400 mg/kg/day, developed an unusual epithelial proliferative process in the renal parenchyma. Morphological and immunohistochemical characterization of the lesions confirmed an invasive malignant epithelial neoplasm (carcinoma). A similar renal neoplasm was seen in a third macaque after a 14-day exposure to a second kinase inhibitor in the same chemical series ((S) 4-((2-(5-chloro-2-fluorophenyl)-5-methoxypyrimidin-4-yl)amino)-N-cyclopropylnicotinamide [SCIO-974]). Despite remarkably short latency periods, exposure to these kinase inhibitors was likely causally associated with the induction of the renal tumors, as renal carcinomas are exceedingly rare spontaneously in macaques. Both SCIO-120 and SCIO-974 were designed as potent TGFβR1 inhibitors (IC50s 37 and 39 nM, respectively). SCIO-120 and SCIO-974 inhibited additional kinases, most notably closely related ALK4 (IC50 = 34 and 20 nM, respectively), c-Jun n-Terminal kinase 3 (JNK3, IC50 = 10 and 20 nM, respectively), and Fms-related tyrosine kinase 1 (29 and 76 nM, respectively). TGFβR1 has been specifically implicated in epithelial proliferative disorders, including neoplasia. Neither SCIO-120 nor SCIO-974 was genotoxic based on bacterial reverse mutation and/or clastogenicity screening assays. The rapid appearance of renal carcinomas in primates following short-term treatment with nongenotoxic kinase inhibitors is remarkable and suggests that the compounds had noteworthy tumor-enhancing effects, hypothetically linked to their TGFβR1 inhibition activity. These observations have implications for mechanisms of carcinogenesis and TGFβR1 biology.
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Affiliation(s)
| | - Andrew M Standeven
- Nonclinical Safety, Janssen R&D, South San Francisco, California 94080, USA
| | - Jing Ying Ma
- Nonclinical Safety, Janssen R&D, San Diego, California 92121, USA
| | - Jerry Hardisty
- Experimental Pathology Laboratories (EPL), Sterling, Virginia 20166, USA
| | - Samuel M Cohen
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, Nebraska 68198-3135, USA
| | - Williams D Kerns
- Department of Nonclinical Drug Development, Accellient Partners, Evergreen, Colorado, USA
| | - Sandra Snook
- Nonclinical Safety, Janssen R&D, San Diego, California 92121, USA
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11
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Gargiuli C, Sepe P, Tessari A, Sheetz T, Colecchia M, de Braud FGM, Procopio G, Sensi M, Verzoni E, Dugo M. Integrative Transcriptomic Analysis Reveals Distinctive Molecular Traits and Novel Subtypes of Collecting Duct Carcinoma. Cancers (Basel) 2021; 13:2903. [PMID: 34200770 PMCID: PMC8230422 DOI: 10.3390/cancers13122903] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/06/2021] [Accepted: 06/08/2021] [Indexed: 12/13/2022] Open
Abstract
Collecting duct carcinoma (CDC) is a rare and highly aggressive kidney cancer subtype with poor prognosis and no standard treatments. To date, only a few studies have examined the transcriptomic portrait of CDC. Through integration of multiple datasets, we compared CDC to normal tissue, upper-tract urothelial carcinomas, and other renal cancers, including clear cell, papillary, and chromophobe histologies. Association between CDC gene expression signatures and in vitro drug sensitivity data was evaluated using the Cancer Therapeutic Response Portal, Genomics of Drug Sensitivity in Cancer datasets, and connectivity map. We identified a CDC-specific gene signature that predicted in vitro sensitivity to different targeted agents and was associated to worse outcome in clear cell renal cell carcinoma. We showed that CDC are transcriptionally related to the principal cells of the collecting ducts providing evidence that this tumor originates from this normal kidney cell type. Finally, we proved that CDC is a molecularly heterogeneous disease composed of at least two subtypes distinguished by cell signaling, metabolic and immune-related alterations. Our findings elucidate the molecular features of CDC providing novel biological and clinical insights. The identification of distinct CDC subtypes and their transcriptomic traits provides the rationale for patient stratification and alternative therapeutic approaches.
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Affiliation(s)
- Chiara Gargiuli
- Platform of Integrated Biology, Department of Applied Research and Technology Development, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy;
| | - Pierangela Sepe
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy; (P.S.); (F.G.M.d.B.); (G.P.); (E.V.)
| | - Anna Tessari
- Department of Cancer Biology and Genetics, College of Medicine and Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA; (A.T.); (T.S.)
| | - Tyler Sheetz
- Department of Cancer Biology and Genetics, College of Medicine and Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA; (A.T.); (T.S.)
- Department of Urology, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA
| | - Maurizio Colecchia
- Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy;
| | - Filippo Guglielmo Maria de Braud
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy; (P.S.); (F.G.M.d.B.); (G.P.); (E.V.)
- Department of Oncology and Hemato-Oncology, University of Milan, 20133 Milan, Italy
| | - Giuseppe Procopio
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy; (P.S.); (F.G.M.d.B.); (G.P.); (E.V.)
| | - Marialuisa Sensi
- Platform of Integrated Biology, Department of Applied Research and Technology Development, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy;
| | - Elena Verzoni
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy; (P.S.); (F.G.M.d.B.); (G.P.); (E.V.)
| | - Matteo Dugo
- Platform of Integrated Biology, Department of Applied Research and Technology Development, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy;
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12
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Qian X, Wang Z, Zhang J, Wang Q, Zhou P, Wang S, Wang B, Qian C. Clinical Features and Prognostic Outcome of Renal Collecting Duct Carcinoma: 12 Cases from a Single Institution. Cancer Manag Res 2020; 12:3589-3595. [PMID: 32547196 PMCID: PMC7245445 DOI: 10.2147/cmar.s244094] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Accepted: 05/07/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose Collecting duct carcinoma (CDC) is extremely rare and has high malignancy and poor prognosis. The purpose of this research is to explore the clinical characteristic, imaging, pathological diagnosis, treatment and prognostic outcome of CDCs. Materials and Methods The clinical data of 12 CDC cases who had been surgically treated between August 2007 and August 2017 and verified the diagnosis of CDC by postoperative pathological and/or immunohistochemical staining (IHC) results were retrospectively analyzed, and related works of literature were reviewed. And Kaplan-Meier survival analysis was used to draw the survival curve and to calculate the survival rate and the median survival time. Results According to the TNM stage system, 4 cases were in stage I, 2 in stage II,3 in stage III, and 3 in stage IV. On the computed tomograph and magnetic resonance imaging, CDC displayed that various shapes, unclear boundary and invasive growth into the renal parenchyma. Compared with small CDCs which did not change the contour of the kidney, large CDCs presented various imaging features. Microscopically, the typical morphology of CDCs was that collecting ducts or tubules were obviously infiltrated by tumor cells. A tubular, papillary, tubulopapillary or solid architectures with desmoplasia were often presented. And tumor cells had high-grade cytology or an infiltrative growth pattern. Necrosis of tumor cells also was common in many cases. The expression of biomarkers, such as PAX-8, INI-1, 34βE12, CK19, PAX-2, and vimentin, in most patients was detected by IHC. Eleven of all 12 cases received radical surgery, of whom 5 patients died 3–11 months after surgery, and 1 case having undergone interventional embolization therapy died at 6 months after treatment due to multiple metastases. And 1 lost to contact. The overall 1-, 2-, and 5-year survival rates were 45.5%, 36.4%, and 8.8%, respectively, and the median survival time (MST) was 11 months. Conclusion CDC has an aggressive clinical course, with a poor prognosis. The best way to treat CDC suspected by imaging examinations is radical surgery which can contribute to confirm the correct histopathological type. And post-operation follow-up is necessary.
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Affiliation(s)
- Xiaoyuan Qian
- Department of Urology Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Zhixian Wang
- Department of Urology Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Jiaqiao Zhang
- Department of Urology Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Qing Wang
- Department of Urology Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Peng Zhou
- Department of Urology Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Shaogang Wang
- Department of Urology Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Bo Wang
- Department of Urology Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Can Qian
- Department of Traditional Chinese Medicine and Rheumatology, Southwest Hospital, Army Military Medical University, Chongqing, China
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13
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Kopeć N, Kopcza P, Wrona A, Salagierski M. Nephron sparing surgery for metastatic collecting duct carcinoma. Cent European J Urol 2020; 72:374-377. [PMID: 32015906 PMCID: PMC6979547 DOI: 10.5173/ceju.2019.0055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Revised: 11/19/2019] [Accepted: 11/22/2019] [Indexed: 01/02/2023] Open
Abstract
Collecting duct carcinoma (CDC) accounts for less than 1% of all renal carcinomas. It is a rare and aggressive neoplasm presenting generally at an advanced stage, and thus has a poor prognosis. The present case describes a 31-year-old female suffering from CDC coexisting with papillary renal cell carcinoma (PRCC) as well as liver, nodal and vertebral metastases. The patient was treated with open nephron sparing surgery. To date, there are only several clinical studies of CDC and few reports of synchronous CDC and PRCC in one kidney.
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Affiliation(s)
- Norbert Kopeć
- Department of Urology, Biernacki Hospital Mielec, Mielec, Poland
| | - Paweł Kopcza
- Department of Urology, Biernacki Hospital Mielec, Mielec, Poland
| | - Andrzej Wrona
- Department of Urology, Biernacki Hospital Mielec, Mielec, Poland
| | - Maciej Salagierski
- Faculty of Medicine and Health Sciences, Urology Department, Zielona Góra, Poland.,Department of Urology, University Hospital, Zielona Góra, Poland
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14
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Wach S, Taubert H, Weigelt K, Hase N, Köhn M, Misiak D, Hüttelmaier S, Stöhr CG, Kahlmeyer A, Haller F, Vera J, Hartmann A, Wullich B, Lai X. RNA Sequencing of Collecting Duct Renal Cell Carcinoma Suggests an Interaction between miRNA and Target Genes and a Predominance of Deregulated Solute Carrier Genes. Cancers (Basel) 2019; 12:E64. [PMID: 31878355 DOI: 10.3390/cancers12010064] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 12/19/2019] [Accepted: 12/22/2019] [Indexed: 02/07/2023] Open
Abstract
Collecting duct carcinoma (CDC) is a rare renal cell carcinoma subtype with a very poor prognosis. There have been only a few studies on gene expression analysis in CDCs. We compared the gene expression profiles of two CDC cases with those of eight normal tissues of renal cell carcinoma patients. At a threshold of |log2fold-change| ≥1, 3349 genes were upregulated and 1947 genes were downregulated in CDCs compared to the normal samples. Pathway analysis of the deregulated genes revealed that cancer pathways and cell cycle pathways were most prominent in CDCs. The most upregulated gene was keratin 17, and the most downregulated gene was cubilin. Among the most downregulated genes were four solute carrier genes (SLC3A1, SLC9A3, SLC26A7, and SLC47A1). The strongest negative correlations between miRNAs and mRNAs were found between the downregulated miR-374b-5p and its upregulated target genes HIST1H3B, HK2, and SLC7A11 and between upregulated miR-26b-5p and its downregulated target genes PPARGC1A, ALDH6A1, and MARC2. An upregulation of HK2 and a downregulation of PPARGC1A, ALDH6A1, and MARC2 were observed at the protein level. Survival analysis of the cancer genome atlas (TCGA) dataset showed for the first time that low gene expression of MARC2, cubilin, and SLC47A1 and high gene expression of KRT17 are associated with poor overall survival in clear cell renal cell carcinoma patients. Altogether, we identified dysregulated protein-coding genes, potential miRNA-target interactions, and prognostic markers that could be associated with CDC.
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15
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Abstract
RATIONALE Collecting duct carcinoma (CDC) is a rare neoplasm arising from the collecting duct and should be distinguished from other renal cell carcinomas that mostly originated from the proximal tubular epithelium and tumors originated from the urothelium. It usually occurs in unilateral kidney, sometimes found with cystic change. PATIENT CONCERNS We present the case of a 53-year-old male suffering from repeated bilateral flank pain for 6 months, increased pain with dysuria for 5 days. DIAGNOSIS Ultrasound showed 2 similar hybrid echo masses in bilateral kidneys with enlarged lymph nodes surrounded, which accords with magnetic resonance imaging (MRI), and intraoperative biopsy reported malignancy. INTERVENTIONS An exploratory operation was performed and the mass on the left kidney was removed, but pathological result reported collecting duct carcinoma according to the morphological features and immunohistochemical tests. Also postsurgery positron emission tomography-computed tomography (PET-CT) confirmed the mass on the left kidney is also a lesion of CDC. OUTCOMES The patient refused chemotherapy and had an overall survival of 7 months. LESSONS We presented a case of CDC involving bilateral kidneys with cystic change; this is the first case of bilateral renal occurrence with cystic change to our knowledge. Because of CDC's rapid growth and the lack of effective adjuvant treatment after surgery, the prognosis is poor and the diagnosis should be made carefully.
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Affiliation(s)
- Guanghui Gong
- Department of Pathology, Xiangya Hospital, Central South University
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University
| | - Ting Lin
- Hunan Provincial Key Laboratory for the Prevention and Treatment of Ophthalmology and Otolaryngology Diseases with Traditional Chinese Medicine
- Hunan Provincial Key Discipline of Chinese Head and Neck Science
| | - Yishu Yuan
- Department of Pathology, Xiangya Hospital, Central South University
| | - Yulai Li
- PET Center of Xiangya Hospital, Central South University
| | - Ruijie Liu
- Department of Pathology, Xiangya Hospital, Central South University
- NHC Key Laboratory of Cancer Proteomics, Xiangya Hospital, Central South University, Changsha, People's Republic of China
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16
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Abstract
Ovarian metastasis is common with secondary tumors representing up to 15% of ovarian neoplasms. The malignancies most commonly involving the ovaries are carcinomas of the stomach, colon, breast, endocervix, endometrium, and lymphoma. Secondary ovarian involvement by kidney carcinoma occurs very rarely and is usually associated with widespread dissemination. We conducted a review of kidney carcinoma with ovarian metastasis in the literature using the keywords clear cell renal cell carcinoma, papillary renal cell carcinoma, chromophobe renal cell carcinoma collecting duct carcinoma, and ovarian metastasis on Google Scholar and PubMed indices in April 2018, including a case diagnosed in our department. To date, 30 articles presenting 41 cases of kidney carcinoma with ovarian metastasis are reported in the literature. All reviewed cases were analyzed for diagnosis, surgical and systemic therapy, and outcome. Diagnosis may sometimes be challenging, requiring appropriate immunohistochemical markers in difficult cases. A combination of surgery and adjuvant therapy offers significant benefit in disease control or palliation of symptoms. Due to inconsistency in the reported data, further studies are needed to make safe conclusions regarding survival.
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Affiliation(s)
| | - Despoina Nasi
- Department of Oncology, "Saint Savvas" Cancer Hospital, Athens, GRC
| | | | - Stefania Kokkali
- Department of Oncology, "Saint Savvas" Cancer Hospital, Athens, GRC
| | - Stamatios Theocharis
- Department of Pathology, National and Kapodistrian University of Athens, Athens, GRC
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17
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Yasuoka S, Hamasaki T, Kuribayashi E, Nagasawa M, Kawaguchi T, Nagashima Y, Kondo Y. Nivolumab therapy for metastatic collecting duct carcinoma after nephrectomy: A case report. Medicine (Baltimore) 2018; 97:e13173. [PMID: 30407350 PMCID: PMC6250451 DOI: 10.1097/md.0000000000013173] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 10/17/2018] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Collecting duct carcinoma (CDC) is a rare type of nonclear renal cell carcinoma, often presenting at an advanced stage of the disease, and standard treatment guidelines have not been established. PATIENT CONCERNS A 73-year-old man was admitted to our hospital with complaints of fever and lower right back pain. DIAGNOSES Computed tomography revealed a poorly defined tumor of the right kidney without metastasis. The patient underwent right radical nephrectomy and was diagnosed with clinical stage T1bN0M0 renal cancer; the pathological findings showed collecting duct carcinoma. INTERVENTIONS After nephrectomy, multiple lung metastases were found in the following month, so first-line chemotherapy of gemcitabine (1000 mg/m on days 1 and 8, every 21 days) and cisplatin (70 mg/m on day 2, every 21 days) was administered. Due to disease progression, targeted therapy with axitinib (10 mg/body) and second-line chemotherapy of paclitaxel (200 mg/m on day 1, every 21 days) and carboplatin (area under the curve of 6 on day 1, every 21 days) were subsequently administered. However, the lung metastases progressed and new metastases spread to the right adrenal gland, liver, and lymph nodes. Based on the high expression of programmed death-ligand 1 in tumor cells, we treated the patient with the immune checkpoint inhibitor nivolumab. OUTCOMES After 2 courses of treatment, he experienced a partial response and improved performance status, and thus was discharged from the hospital. To date, the patient is on his fifth course of treatment as an outpatient without disease progression. LESSONS The findings of our study suggest that nivolumab may be effective even if the patient has highly progressive CDC with a low PS, if PD-L1 is highly expressed in the tumor cells.
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Affiliation(s)
| | | | | | | | - Takanori Kawaguchi
- Department of Pathology, Aidu Chuo Hospital, Tsurugacho, Aiduwakamatu-shi, Fukushima
| | - Yoji Nagashima
- Department of Surgical Pathology, Tokyo Women‘s Medical University Hospital, 8-1 Kawada-cho, Shinjuku-ku
| | - Yukihiro Kondo
- Department of Urology, Nippon Medical School Hospital, Sendagi, Bunkyo-ku, Tokyo, Japan
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18
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Singh JA, Ohe C, Smith SC. High grade infiltrative adenocarcinomas of renal cell origin: New insights into classification, morphology, and molecular pathogenesis. Pathol Int 2018; 68:265-277. [PMID: 29665139 DOI: 10.1111/pin.12667] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Accepted: 03/02/2018] [Indexed: 12/11/2022]
Abstract
Collecting duct carcinoma was described over 30 years ago as a renal tumor, based in the medullary collecting system, with tubulopapillary morphology, prominent infiltrative growth, and stromal desmoplasia. While diagnostic workup has always emphasized exclusion of upper tract urothelial carcinoma and metastatic adenocarcinoma to the kidney, the molecular era of renal cell carcinoma classification has enabled recognition of and provided tools for diagnosis of new entities in this morphologic differential. In this review, we consider these developments, with emphasis on renal medullary carcinoma, closely related renal cell carcinoma, unclassified with medullary phenotype, and fumarate hydratase-deficient renal cell carcinoma. Integration of ancillary studies with suggestive patterns of morphology is emphasized for practical implementation in contemporary diagnosis, and several emerging tumor types in the morphologic differential are presented.
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Affiliation(s)
- Jaime A Singh
- Department of Pathology, VCU School of Medicine, Richmond, VA, USA
| | - Chisato Ohe
- Department of Pathology and Laboratory Medicine, Kansai Medical University, Osaka, Japan
| | - Steven Christopher Smith
- Department of Pathology, VCU School of Medicine, Richmond, VA, USA.,Division of Urology, Department of Surgery, VCU School of Medicine, Richmond, VA, USA
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19
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Dao M, Pécriaux A, Bessede T, Dürrbach A, Mussini C, Guettier C, Ferlicot S. BK virus-associated collecting duct carcinoma of the renal allograft in a kidney-pancreas allograft recipient. Oncotarget 2018; 9:15157-15163. [PMID: 29599935 PMCID: PMC5871106 DOI: 10.18632/oncotarget.24552] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 02/10/2018] [Indexed: 01/01/2023] Open
Abstract
BK polyomavirus (BKV) nephropathy is a major concern in renal transplantation. Its main consequence is graft loss, which occurs in more than 50% of the cases. De novo renal cell carcinoma in renal allograft is a very rare event. Most of these tumors are papillary or clear cell carcinomas. We report herein the first case of collecting duct carcinoma of the renal allograft in a kidney-pancreas allograft adult recipient. Collecting duct carcinoma occurs long after the cure of a BKV nephropathy. At this time, BKV viremia and viruria were negative as well as the immunostaining for SV40 in the non-tumor kidney. The viral oncoprotein Tag persists only in the tumor cells. To preserve pancreas graft function, we maintained immunosuppression levels. After a 9-months follow-up, the evolution was free from clinical and radiological progression. The oncogenic role of BKV remains controversial in human cancers. However, strong experimental data have shown an association between BKV infection and urologic neoplasms. Further works might precise the exact role of polyomaviruses in renal carcinogenesis. In the meantime, clinical vigilance for early diagnostic of these tumors is mandatory after BKV nephropathy.
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Affiliation(s)
- Myriam Dao
- Pathology Department, CHU Bicêtre, Le Kremlin-Bicêtre, France.,University Paris-Sud, Le Kremlin-Bicêtre, France
| | - Adrien Pécriaux
- Pathology Department, CHU Bicêtre, Le Kremlin-Bicêtre, France
| | - Thomas Bessede
- University Paris-Sud, Le Kremlin-Bicêtre, France.,Urology Department, CHU Bicêtre, Le Kremlin-Bicêtre, France
| | - Antoine Dürrbach
- University Paris-Sud, Le Kremlin-Bicêtre, France.,Nephrology Department, CHU Bicêtre, Le Kremlin-Bicêtre, France
| | | | - Catherine Guettier
- Pathology Department, CHU Bicêtre, Le Kremlin-Bicêtre, France.,University Paris-Sud, Le Kremlin-Bicêtre, France
| | - Sophie Ferlicot
- Pathology Department, CHU Bicêtre, Le Kremlin-Bicêtre, France.,University Paris-Sud, Le Kremlin-Bicêtre, France
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20
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Wang J, Papanicolau-Sengos A, Chintala S, Wei L, Liu B, Hu Q, Miles KM, Conroy JM, Glenn ST, Costantini M, Magi-Galluzzi C, Signoretti S, Choueiri T, Gallucci M, Sentinelli S, Fazio VM, Poeta ML, Liu S, Morrison C, Pili R. Collecting duct carcinoma of the kidney is associated with CDKN2A deletion and SLC family gene up-regulation. Oncotarget 2017; 7:29901-15. [PMID: 27144525 PMCID: PMC5058651 DOI: 10.18632/oncotarget.9093] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 04/16/2016] [Indexed: 01/17/2023] Open
Abstract
The genetic landscape and molecular features of collecting duct carcinoma (CDC) of the kidney remain largely unknown. Herein, we performed whole exome sequencing (WES) and transcriptome sequencing (RNASeq) on 7 CDC samples (CDC1 −7). Among the 7 samples, 4 samples with matched non-tumor tissue were used for copy number analysis by SNP array data. No recurrent somatic SNVs were observed except for MLL, which was found to be mutated (p.V297I and p.F407C) in 2 samples. We identified somatic SNVs in 14 other cancer census genes including: ATM, CREBBP, PRDM1, CBFB, FBXW7, IKZF1, KDR, KRAS, NACA, NF2, NUP98, SS18, TP53, and ZNF521. SNP array data identified a CDKN2A homozygous deletion in 3 samples and SNV analysis showed a non-sense mutation of the CDKN2A gene with unknown somatic status. To estimate the recurrent rate of CDKN2A abnormalities, we performed FISH screening of additional samples and confirmed the frequent loss (62.5%) of CDKN2A expression. Since cisplatin based therapy is the common treatment option for CDC, we investigated the expression of solute carrier (SLC) family transporters and found 45% alteration. In addition, SLC7A11 (cystine transporter, xCT), a cisplatin resistance associated gene, was found to be overexpressed in 4 out of 5 (80%) cases of CDC tumors tested, as compared to matched non-tumor tissue. In summary, our study provides a comprehensive genomic analysis of CDC and identifies potential pathways suitable for targeted therapies.
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Affiliation(s)
- Jianmin Wang
- Department of Biostatistics & Bioinformatics, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Antonios Papanicolau-Sengos
- Department of Pathology and Center for Personalized Medicine, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Sreenivasulu Chintala
- Genitourinary Program, Roswell Park Cancer Institute, Buffalo, NY, USA.,Genitourinary Program, Indiana University-Simon Cancer Center, Indianapolis, IN, USA
| | - Lei Wei
- Department of Biostatistics & Bioinformatics, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Biao Liu
- Department of Biostatistics & Bioinformatics, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Qiang Hu
- Department of Biostatistics & Bioinformatics, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Kiersten Marie Miles
- Department of Pathology and Center for Personalized Medicine, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Jeffrey M Conroy
- Department of Pathology and Center for Personalized Medicine, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Sean T Glenn
- Cancer Genetics, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Manuela Costantini
- Department of Urology, Regina Elena National Cancer Institute of Rome, Rome, Italy.,Laboratory of Genetic and Clinical Pathology, University Campus BioMedico of Rome, Rome, Italy.,Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari, Bari, Italy
| | | | - Sabina Signoretti
- Department of Pathology and Kidney Cancer Program, Dana Farber, Boston, MA, USA
| | - Toni Choueiri
- Department of Pathology and Kidney Cancer Program, Dana Farber, Boston, MA, USA
| | - Michele Gallucci
- Department of Urology, Regina Elena National Cancer Institute of Rome, Rome, Italy
| | - Steno Sentinelli
- Department of Urology, Regina Elena National Cancer Institute of Rome, Rome, Italy
| | - Vito M Fazio
- Laboratory of Genetic and Clinical Pathology, University Campus BioMedico of Rome, Rome, Italy
| | - Maria Luana Poeta
- Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari, Bari, Italy
| | - Song Liu
- Department of Biostatistics & Bioinformatics, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Carl Morrison
- Department of Pathology and Center for Personalized Medicine, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Roberto Pili
- Genitourinary Program, Roswell Park Cancer Institute, Buffalo, NY, USA.,Genitourinary Program, Indiana University-Simon Cancer Center, Indianapolis, IN, USA
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21
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Mizutani K, Horie K, Nagai S, Tsuchiya T, Saigo C, Kobayashi K, Miyazaki T, Deguchi T. Response to nivolumab in metastatic collecting duct carcinoma expressing PD-L1: A case report. Mol Clin Oncol 2017; 7:988-990. [PMID: 29285361 PMCID: PMC5740828 DOI: 10.3892/mco.2017.1449] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 08/16/2017] [Indexed: 12/28/2022] Open
Abstract
The authors present a case report of collecting duct carcinoma (CDC) that responded to nivolumab, a programmed death 1 (PD-1) immune-checkpoint-inhibitor antibody, following the failure of systemic treatment with chemotherapy and targeted therapy. The patient underwent right radical nephrectomy and segmentectomy of the lung following chemotherapy. Fifteen months following the first surgery, segmentectomy and subsequent second-line chemotherapy were performed for recurrence in the lung. Targeted therapy with temsirolimus for recurrence of the lung and lymph node metastases was ultimately used for 30 months. However, the temsirolimus treatment failed to suppress the growth of metastatic lesions. Nivolumab resulted in complete response of the lung metastasis, and it stabilized the lymph node metastasis. PD-L1 was highly expressed in both primary tumor and the metastatic regions. Therapy with nivolumab is ongoing. These findings suggest that treatment with nivolumab may be considered for metastatic and treatment-failure CDC.
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Affiliation(s)
- Kosuke Mizutani
- Department of Urology, Gifu University Graduate School of Medicine, Gifu, Gifu 501-1194 Japan
| | - Kengo Horie
- Department of Urology, Gifu University Graduate School of Medicine, Gifu, Gifu 501-1194 Japan
| | - Shingo Nagai
- Department of Urology, Gifu University Graduate School of Medicine, Gifu, Gifu 501-1194 Japan
| | - Tomohiro Tsuchiya
- Department of Urology, Gifu University Graduate School of Medicine, Gifu, Gifu 501-1194 Japan
| | - Chiemi Saigo
- Pathology Division, Gifu University Hospital, Gifu, Gifu 501-1194 Japan
| | | | | | - Takashi Deguchi
- Department of Urology, Gifu University Graduate School of Medicine, Gifu, Gifu 501-1194 Japan
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22
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Young JR, Young JA, Margolis DJA, Sauk S, Sayre J, Pantuck AJ, Raman SS. Sarcomatoid Renal Cell Carcinoma and Collecting Duct Carcinoma: Discrimination From Common Renal Cell Carcinoma Subtypes and Benign RCC Mimics on Multiphasic MDCT. Acad Radiol 2017; 24:1226-1232. [PMID: 28528853 DOI: 10.1016/j.acra.2017.03.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 03/16/2017] [Accepted: 03/21/2017] [Indexed: 11/17/2022]
Abstract
RATIONALE AND OBJECTIVES To investigate whether imaging features on multiphasic multidetector computed tomography (MDCT) can help discriminate sarcomatoid renal cell carcinoma (RCC) and collecting duct carcinoma (CDC) from other solid renal masses. MATERIALS AND METHODS With institutional review board approval for this HIPAA-compliant study, we derived a cohort of 7 sarcomatoid RCCs, 4 CDCs, 165 clear cell RCCs, 56 papillary RCCs, 22 chromophobe RCCs, 49 oncocytomas, and 16 lipid-poor angiomyolipomas with preoperative multiphasic MDCT with up to four phases (unenhanced, corticomedullary, nephrographic, and excretory). Each lesion was reviewed for contour, spread pattern, pattern of enhancement, neovascularity, and calcification. RESULTS Sarcomatoid RCCs and CDCs were more likely than other solid renal masses to have an irregular contour (64% vs 2%, P < 0.001) and an infiltrative spread pattern, defined as infiltration into adjacent renal parenchyma, collecting system, or neighboring structures (82% vs 7%, P < 0.001). When used to discriminate sarcomatoid RCC and CDC from other solid renal masses, an infiltrative spread pattern had a specificity of 93% (287/308) and sensitivity of 82% (9/11), and an irregular contour had a specificity of 98% (303/308) and sensitivity of 64% (7/11). CONCLUSIONS Solid renal lesions with an irregular contour or an infiltrative spread pattern are suspicious for sarcomatoid RCC or CDC.
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MESH Headings
- Adenoma, Oxyphilic/diagnostic imaging
- Adenoma, Oxyphilic/pathology
- Adult
- Aged
- Aged, 80 and over
- Angiomyolipoma/diagnostic imaging
- Angiomyolipoma/pathology
- Carcinoma, Ductal/diagnostic imaging
- Carcinoma, Ductal/pathology
- Carcinoma, Papillary/diagnostic imaging
- Carcinoma, Papillary/pathology
- Carcinoma, Renal Cell/diagnostic imaging
- Carcinoma, Renal Cell/pathology
- Diagnosis, Differential
- Female
- Humans
- Kidney Neoplasms/diagnostic imaging
- Kidney Neoplasms/pathology
- Male
- Middle Aged
- Multidetector Computed Tomography
- Retrospective Studies
- Sensitivity and Specificity
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Affiliation(s)
- Jonathan R Young
- Department of Radiology, David Geffen School of Medicine at UCLA, 757 Westwood Plaza, Suite 1638, Los Angeles, CA 90095-7437.
| | - Jocelyn A Young
- Department of Radiology, David Geffen School of Medicine at UCLA, 757 Westwood Plaza, Suite 1638, Los Angeles, CA 90095-7437
| | - Daniel J A Margolis
- Department of Radiology, David Geffen School of Medicine at UCLA, 757 Westwood Plaza, Suite 1638, Los Angeles, CA 90095-7437
| | - Steven Sauk
- Department of Radiology, David Geffen School of Medicine at UCLA, 757 Westwood Plaza, Suite 1638, Los Angeles, CA 90095-7437
| | - James Sayre
- Department of Radiology, David Geffen School of Medicine at UCLA, 757 Westwood Plaza, Suite 1638, Los Angeles, CA 90095-7437
| | - Allan J Pantuck
- Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Steven S Raman
- Department of Radiology, David Geffen School of Medicine at UCLA, 757 Westwood Plaza, Suite 1638, Los Angeles, CA 90095-7437
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23
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Zhao M, Teng X, Ru G, Zhao Z, Hu Q, Han L, He X. Tubulocystic renal cell carcinoma with poorly differentiated foci is indicative of aggressive behavior: clinicopathologic study of two cases and review of the literature. Int J Clin Exp Pathol 2015; 8:11124-11131. [PMID: 26617832 PMCID: PMC4637647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 08/20/2015] [Indexed: 06/05/2023]
Abstract
Tubulocystic renal cell carcinoma (TCRCC) is a rare, recently characterized RCC subtype with distinctive clinicopathologic and genetic characterizations as well as typical behaviors in an indolent fashion. However, sporadic case reports in the literature have indicated that TCRCC with sarcomatoid differentiation or poorly differentiated (PD) foci could behave aggressively. Herein, we reported two cases of TCRCC with PD foci indentified from our consultative service. Both patients were male and aged 66 y and 47 y, respectively. The first patient experienced radical nephrectomy while the other was treated by partial nephrectomy. Macroscopically, both tumors were described as partly cystic and solid with the greatest diameter measuring of 12-cm and 4.5-cm, respectively. Histologically, both lesions had classic areas of TCRCC occupying most part of the tumor with small papillary RCC component. In case one, PD foci were scatteredly distributed and mixed with TCRCC and papillary RCC components, while in the other case the PD foci were adjacent to the areas of TCRCC. In both tumors, the PD foci were composed of irregular, often angulated, small tubules lined by atypical eosinophilic cells and surrounded by desmoplastic stroma, resembling collecting duct carcinoma. Immunohistochemistry, in both tumors, both TCRCC component and PD foci showed the similar immunoprofiles, i.e., labeling strongly and diffusely with PAX8, AMACR and Vimentin, and focally with CK34βE12 but not with renal cell carcinoma marker or P63. In case one, the tumor invaded extensively into the adjacent renal parenchyma and focally into both renal sinusal and perirenal adipose tissues. The patient had metastasis in the pelvic cavity at the time of diagnosis and succumbed to the disease without further treatment 3 months later. The other case was organ confined but with focal positive renal parenchymal margin. The patient subsequently underwent radical nephrectomy and was in a good status without evidence of tumor recurrence or metastasis at a follow-up of 8 months.
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MESH Headings
- Aged
- Biomarkers, Tumor/analysis
- Biopsy
- Carcinoma, Renal Cell/chemistry
- Carcinoma, Renal Cell/secondary
- Carcinoma, Renal Cell/surgery
- Cell Differentiation
- Disease Progression
- Fatal Outcome
- Humans
- Immunohistochemistry
- Kidney Neoplasms/chemistry
- Kidney Neoplasms/pathology
- Kidney Neoplasms/surgery
- Male
- Middle Aged
- Neoplasm Invasiveness
- Neoplasms, Cystic, Mucinous, and Serous/chemistry
- Neoplasms, Cystic, Mucinous, and Serous/secondary
- Neoplasms, Cystic, Mucinous, and Serous/surgery
- Nephrectomy
- Pelvic Neoplasms/secondary
- Time Factors
- Treatment Outcome
- Tumor Burden
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Affiliation(s)
- Ming Zhao
- Department of Pathology, Zhejiang Provincial People’s HospitalHangzhou 310014, Zhejiang, PR China
| | - Xiaodong Teng
- Department of Pathology, The First Affiliated Hospital, Zhejiang University College of MedicineHangzhou 310003, Zhejiang, China
| | - Guoqing Ru
- Department of Pathology, Zhejiang Provincial People’s HospitalHangzhou 310014, Zhejiang, PR China
| | - Zhongsheng Zhao
- Department of Pathology, Zhejiang Provincial People’s HospitalHangzhou 310014, Zhejiang, PR China
| | - Qinqin Hu
- Department of Pathology, Zhejiang Provincial People’s HospitalHangzhou 310014, Zhejiang, PR China
| | - Likai Han
- Department of Pathology, Zhejiang Provincial People’s HospitalHangzhou 310014, Zhejiang, PR China
| | - Xianglei He
- Department of Pathology, Zhejiang Provincial People’s HospitalHangzhou 310014, Zhejiang, PR China
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24
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Hu YU, Zhou H, Wang G, Song Z, Zhao C, Wang Y. Collecting duct carcinoma of the kidney: A case report. Oncol Lett 2015; 9:2902-2904. [PMID: 26137167 DOI: 10.3892/ol.2015.3085] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 03/13/2015] [Indexed: 12/20/2022] Open
Abstract
Collecting duct carcinoma (CDC) is a rare type of renal tumor, arising from the distal collecting ducts. The prognosis of this disease is extremely poor due to its rapid progression with widespread metastases. The present study reported a case of CDC involving the right renal region of a 62-year-old female patient, presented with right-flank pain that had persisted for one month. A computed tomography scan demonstrated multiple hypoattenuating quasicircular lesions, 0.5-4.3 cm in size, in the upper pole of the right kidney. Following the diagnosis of a right renal tumor, laparoscopic radical resection of the right kidney was performed. Pathological examination demonstrated that the tumor cells were arranged in a glandular or papillary pattern, and marked cytological atypia was observed. Immunohistochemical staining revealed that the tumor cells were positive for epithelial membrane antigen and cytokeratin (CK)7, while they reacted focally with vimentin. However, the tumor cells were negative for CK20, CD10, uroplakin III and p63. Based on these findings, the patient was diagnosed with CDC. In conclusion, immunohistochemical analysis is critical in establishing an accurate diagnosis of CDC and distinguishing this tumor from other subtypes of RCC.
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Affiliation(s)
- Y U Hu
- Department of Pathology, Sino-Japanese Friendship Hospital, Jilin University, Changchun, Jilin 130033, P.R. China
| | - Honglan Zhou
- Department of Urology, First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Gang Wang
- Department of Urology, First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Zhiming Song
- Department of Arthroscopy, First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Chengwu Zhao
- Department of Arthroscopy, First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Yuantao Wang
- Department of Urology, First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
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25
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Hu Y, Lu GM, Li K, Zhang LJ, Zhu H. Collecting duct carcinoma of the kidney: Imaging observations of a rare tumor. Oncol Lett 2013; 7:519-524. [PMID: 24396480 PMCID: PMC3881913 DOI: 10.3892/ol.2013.1739] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Accepted: 11/26/2013] [Indexed: 11/24/2022] Open
Abstract
Collecting duct carcinoma (CDC) is a rare type of renal neoplasm. Early diagnosis is possibly the only factor leading to a prolonged survival for patients with CDC. The purpose of the present study was to characterize the imaging features of CDC and improve its diagnosis. Radiological data of six patients were retrospectively reviewed by three experienced radiologists, including six cases examined with non-contrast computed tomography (CT) scans, five with contrast-enhanced CT scans, one with magnetic resonance urography, one with renal dynamic imaging and two with conventional whole-body 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT scans. All patients were pathologically confirmed with CDC. In total, seven tumors were detected in the six cases, with a mean size of 5.3 cm. Of the tumors, two were solid and the rest were complex solid and cystic. In addition, six tumors were located in medullary areas and only one tumor was found in the cortical location. Cystic components were observed in five tumors. Weak enhancements were observed in all six tumors examined with contrast-enhanced CT, and heterogeneous enhancements were also observed in the majority of these tumors with the exception of one tumor. Infiltrative growth and expansible growth were found in five and two tumors, respectively. Metastatic lesions were detected in all six patients. On MR urography, the involved kidney exhibited similar imaging observations to the CT scan. Renal dynamic imaging revealed a decreased renal function in the involved kidney and an increased renal function in the contralateral kidney. On PET/CT imaging, a marked uptake of 18F-FDG was found in primary and metastatic lesions. The results of the present study indicated that medullary location, weak and heterogeneous enhancement, infiltrative growth, damage of renal function in the involved kidney and a marked uptake of 18F-FDG are imaging observations commonly identified in patients with CDC. When a renal tumor exhibits these imaging features, CDC may be suggested as a valuable differential diagnosis.
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Affiliation(s)
- Yuxiao Hu
- Department of Nuclear Medicine, Jinling Hospital, Clinical School of Medical College, Nanjing University, Nanjing, Jiangsu 210002, P.R. China
| | - Guang-Ming Lu
- Department of Medical Imaging, Jinling Hospital, Clinical School of Medical College, Nanjing University, Nanjing, Jiangsu 210002, P.R. China
| | - Kai Li
- Department of Pharmacology, Soochow University, Suzhou, Jiangsu 215123, P.R. China
| | - Long-Jiang Zhang
- Department of Medical Imaging, Jinling Hospital, Clinical School of Medical College, Nanjing University, Nanjing, Jiangsu 210002, P.R. China
| | - Hong Zhu
- Department of Nuclear Medicine, Jinling Hospital, Clinical School of Medical College, Nanjing University, Nanjing, Jiangsu 210002, P.R. China
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26
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Suh JH, Oak T, Ro JY, Truong LD, Ayala AG, Shen SS. Clinicopathologic features of renal cell carcinoma in young adults: a comparison study with renal cell carcinoma in older patients. Int J Clin Exp Pathol 2009; 2:489-493. [PMID: 19294008 PMCID: PMC2655150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/10/2008] [Accepted: 01/20/2009] [Indexed: 05/27/2023]
Abstract
To evaluate the clinicopathologic features of renal cell carcinoma in younger adults (</=40 years), we retrospectively reviewed 838 consecutive cases of renal cell carcinoma (RCC) occurred in a single tertiary hospital. Forty-four 44 (5.2%) cases occurred in the young adult group (24 to 40 years of age). Clinicopathologic features including tumor size, stage, histologic subtype, lymph node and distant metastasis, and overall survival were compared with that of cases occurred in older age group (>40 years). The tumor size of the young adult group were smaller (5.3 vs 5.9 cm) and presented at less advanced stages (T3/T4 tumors, 18% vs 31%) than those occurring in the older age group (>40 years of age). The incidences of chromophobe RCC (12% vs. 6%) and of collecting duct carcinoma (5% vs 0.5%) were higher in the young adult group. The rate of nodal or distant metastasis was lower in young adult group (5% vs. 8.3%). More patients underwent partial nephrectomy in younger than older age group (30% vs 19%). There was no overall survival difference at 5 years (77% vs 70%), but there was a trend for a favorable survival in young adults at 10 years (77% vs 52%). In conclusion, RCC are relatively infrequent in patients who are younger than 40 years. The tumors in this group appear to be smaller and less advanced at presentation. Chromophobe RCC and collecting duct carcinoma are more frequently seen. More patients undergo partial nephrectomy and overall long term survival appears to be more favorable.
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Affiliation(s)
- Jae Hee Suh
- Department of Pathology, Ulsan University HospitalUlsan, Korea
| | - Tina Oak
- Department of Pathology, The Methodist Hospital and Research Institute, Weill Medical College of Cornell UniversityHouston, TX 77030
| | - Jae Y. Ro
- Department of Pathology, The Methodist Hospital and Research Institute, Weill Medical College of Cornell UniversityHouston, TX 77030
| | - Luan D. Truong
- Department of Pathology, The Methodist Hospital and Research Institute, Weill Medical College of Cornell UniversityHouston, TX 77030
| | - Alberto G. Ayala
- Department of Pathology, The Methodist Hospital and Research Institute, Weill Medical College of Cornell UniversityHouston, TX 77030
| | - Steven S. Shen
- Department of Pathology, The Methodist Hospital and Research Institute, Weill Medical College of Cornell UniversityHouston, TX 77030
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