S66 Complicated renal cyst or papillary renal cell carcinoma – a difficult differential diagnosis

2009 ◽  
Vol 8 (8) ◽  
pp. 629
Author(s):  
M. Ikic ◽  
X. Krah ◽  
G. Atanassov ◽  
E. Hauschild ◽  
G. Eschholz
Urology ◽  
2009 ◽  
Vol 74 (4) ◽  
pp. S259
Author(s):  
E. Hauschild ◽  
X. Krah ◽  
B. Henkel ◽  
G. Atanassov ◽  
M. Ikic ◽  
...  

Author(s):  
Nadir Kalfazade ◽  
Ekrem Güner

Objective: Our objective in this study was to present the data for patients followed-up and underwent surgery due to complex renal cyst using Bosniak classification system. Method: Data of all patients followed-up or underwent surgery via open / minimal invasive methods due to complex renal cyst in our clinic between 2016 and 2019 were retrospectively evaluated. Bosniak category IIF and higher lesions were included in the study. Results: A total of 83 patients were included in the study. The mean age of the patients was 52 ±10.1 years and 40 (48.2%) were male and 43 (51.8%) were female. 53 (63.9%) patients had Bosniak IIF, 18 (21.7%) patients had Bosniak III and 12 (14.5%) patients had Bosniak IV lesions. Mean lesion size was 54±27.4 mm. Surgery was performed in a total of 41 (49.4%) patients. Based on final pathology result, while benign pathologies were detected in 13 (31.7%) patients, clear cell renal cell carcinoma was detected in 22 (53.7%) patients and papillary renal cell carcinoma in 6 (14.6%) patients. Malignity rates were detected as 18.9%, 44.4% and 83.3% in Bosniak IIF, III and IV lesions respectively. While the mean lesion size of patients who had benign pathology were 64.6±18.4 mm, mean lesion size of patients with malign pathology were 58.3±29.7 mm (p =.41). Conclusion: Progression is an important malignity finding in Bosniak IIF lesions. An important amount of especially Bosniak III lesions is overtreated. Thus, active surveillance is a treatment which should be considered in these patients. More comprehensive prospective randomized studies are needed.


Diagnostics ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. 123
Author(s):  
Francesca Giunchi ◽  
Tania Franceschini ◽  
Elisa Gruppioni ◽  
Annalisa Altimari ◽  
Elisa Capizzi ◽  
...  

Background: Clear cell tubulo-papillary renal cell carcinoma (cctpRCC) is characterized by clear cell morphology, but differs from conventional clear cell carcinoma (ccRCC) for its indolent clinical behavior and genetic background. The differential diagnosis between the two is based on histology and immunohistochemistry (IHC). Methods: We performed a comparative case-control histological, IHC, and genetic analysis by next generation sequencing (NGS), to point out the differences in 10 cases of cctpRCC, and six controls of ccRCC with low stage and grade. Results: All 16 cases showed the IHC profile with cytokeratin 7, racemase, and carbonic anhydrase IX expected for the histological features of each tumor type. By contrast, the NGS mutation analysis that covered 207 amplicons of 50 oncogenes or tumor suppressor genes provided conflicting results. Among the 10 cctpRCC cases, eight (80%) were wild type for all of the genes in the panel, while two (20%) harbored VHL mutations typical of ccRCC. Three of the six (50%) ccRCC control cases showed expected VHL mutations; two (33%) harbored pathogenic mutations in the p53 or the CKIT genes; and one (16%) was wild type. Conclusion: We can assume that histology and ICH are not sufficient for a definitive diagnosis of cctpRCC or ccRCC. Although with a panel covering 50 genes, we found that 80% of cctpRCC were genetically silent; thus, suggesting an indolent biology of these tumors. The differential diagnosis between ccptRCC and ccRCC for the choice of the best therapeutic strategy likely requires the comprehensive evaluation of histology, IHC, and at least VHL mutations.


Author(s):  
Dr Suneetha K. P. ◽  
Dr Dilip Javali ◽  
Dr Gayathri J.

Multilocular cystic renal cell carcinomas (RCC’s), Unilocular cystic RCC’s and RCC’s with extensive cystic necrosis and unilocular cysts with mural tumor nodules forms a wide category of RCC’s. Cystic RCC’s represent upto 3-14% of all RCC’s.[1] Here we present a case of 68 year old female who is a known case of DM, hypothyroidism, bronchial asthma presenting with complains of pain abdomen since 1 year. She has been a case of renal TB and on ATT 30 years ago. Further the patient was evaluatedand foundto have a small partly exophytic cortical cyst measuring 13x12mm noted in the inter polar region posteriorly along with multiple well defined hyper dense non enhancing cortical and exohytic cysts notes in upper / lower and inter polar regions, largest measuring 1.8x1.7cms in upper pole suggestive of hemorrhagic cysts. A diagnosis of left renal complex cyst was made. Alaporoscopic left partial cystectectomy was done and sent for histopathological examination. Microscopy revealed Cystic clear cell fgv Renal cell carcinoma, Furhman Grade 1(Low grade) within a 0.1cm thickening which was further confirmed with IHC expressing strongly for CK7,PAX8 and CAIXand confirmed the diagnosis as Clear cell Papillary Renal cell carcinoma. Patient is being followed up and no recurrence / metastasis has been reported. This provides us an opportunity to consider an unusual finding of Clear Cell Papillary RCC in a complex renal cyst and to look into the cystic lesion with more importance helping us in avoiding missing a carcinoma as found in the present case.


2003 ◽  
Vol 37 (5) ◽  
pp. 221-222 ◽  
Author(s):  
P.J Bastian ◽  
J Vogel ◽  
M Feldmann ◽  
H.-P Bastian

2013 ◽  
Vol 7 (3-4) ◽  
pp. E176-179 ◽  
Author(s):  
Jeffrey K. Mullins ◽  
Ronald Rodriguez

We report the case of a 68-year-old male with extension of papillary renal cell carcinoma (Fuhrman grade III) along a percutanous biopsy tract detected at the time of partial nephrectomy. Biopsy was performed to a obtain tissue diagnosis of a complex renal cyst as the patient was unable to receive intravenous contrast for imaging due to a severe allergy. Although biopsy of indeterminate renal lesions can provide valuable diagnostic information, there are inherent risks associated with this procedure. The rare occurrence of tumour seeding should be considered when recommending percutaneous biopsy to a patient with a renal mass.


Sign in / Sign up

Export Citation Format

Share Document