scholarly journals Bellini Duct Carcinoma Misdiagnosed with Urothelial Papillary Carcinoma

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Joey El Khoury ◽  
Maher Abdessater ◽  
Rami Halabi ◽  
Fadi Nasr ◽  
Johnny Boustany ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Papillary Carcinoma ◽  
Renal Pelvis ◽  
Correct Diagnosis ◽  
Transitional Cell ◽  
Psoas Muscle ◽  
Macroscopic Hematuria ◽  
Duct Carcinoma ◽  
Clinical Presentations ◽  
Bellini Duct Carcinoma

Background. Collecting (Bellini) duct carcinoma (CDC) or Bellini duct carcinoma (BDC) is a rare subtype of kidney tumors, accounting for less than 3% and known to have the worst prognosis. It is known to have multiple clinical presentations; this is why it can be easily misdiagnosed. The aim of this article is to present a case of CDC that was initially misdiagnosed with urothelial papillary carcinoma (UPC) in a 41-year-old male. Case Presentation. Our patient presented with a left flank pain evolving for one month and one episode of gross macroscopic hematuria. Upon presentation, he had left costovertebral angle tenderness. Initial lab tests were normal. Computed tomography revealed a 5 cm solid mass of the left renal pelvis and multiple infracentimetric perihilar lymph nodes. Subsequently, the patient had left nephroureterectomy. Microscopic examination showed the presence of a high-grade urothelial papillary carcinoma of the renal pelvis’ lumen. All four of the dissected lymph nodes showed disease metastasis. Three years after establishing the diagnosis, the patient presented again for chronic abdominal pain, with a recent history of weight loss. CT scan showed a left paraaortic mass infiltrating the left psoas muscle over a length of 12 cm. Immunohistochemical profiling of this mass confirmed the diagnosis of Bellini duct carcinoma, rejecting the initial diagnosis of UPC. Therefore, the patient required a cisplatin-gemcitabine-based chemotherapy regimen. Conclusion. BDC remains one of the rare aggressive subtypes of RCC, having a multitude of initial clinical presentations and an unfavorable prognosis. In this patient, CDC was masquerading as a transitional cell carcinoma that should always be kept in mind as a possible presentation. Corresponding early imaging and histopathology exams are primordial for a correct diagnosis and thus a better prognosis.

Microcystic Transitional Cell Carcinoma

2002 ◽  
Vol 126 (7) ◽  
pp. 859-861 ◽  
Author(s):  
Xavier Leroy ◽  
Emmanuelle Leteurtre ◽  
Alexandre De La Taille ◽  
David Augusto ◽  
Jacques Biserte ◽  
...  
Keyword(s):  
Transitional Cell Carcinoma ◽  
Urothelial Carcinoma ◽  
Cell Carcinoma ◽  
Renal Pelvis ◽  
Transitional Cell ◽  
Macroscopic Hematuria ◽  
Computed Tomographic ◽  
First Case ◽  
History Of ◽  
Invasive Transitional Cell Carcinoma

Abstract Microcystic transitional cell carcinoma is a rare variant of urothelial carcinoma; to date, it has been described only in the urinary bladder. We report 2 cases of microcystic transitional cell carcinoma arising in the renal pelvis. The first case occurred in a 73-year-old man with a history of superficially invasive transitional cell carcinoma who presented with macroscopic hematuria and anemia. The second case occurred in a 62-year-old woman who had no relevant medical history and presented with hematuria. Computed tomographic scan revealed a tumor of the renal pelvis. In both cases, microscopic examination showed invasive transitional cell carcinoma with prominent cystic features. The cysts were irregular in size and were deeply infiltrative. The cysts were lined by single or multiple layers of cuboidal or flattened cells with minimal cytological atypia. The first patient died of his disease 18 months after presentation. The second patient remained well at her 6-month follow-up examination. Microcystic transitional cell carcinoma is an unusual, deceptively bland variant of urothelial carcinoma, which can mimic benign lesions.

Is squamous cell histology an adverse prognosticator for survival of malignancies of the upper urinary tract?

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 6617-6617
Author(s):  
T. Rizack ◽  
A. Mega ◽  
D. Berz
Keyword(s):  
Lymph Node ◽  
Urinary Tract ◽  
Lymph Nodes ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Renal Pelvis ◽  
Clinical Stage ◽  
Transitional Cell ◽  
Upper Urinary Tract ◽  
Lymph Node Status

6617 Background: Carcinomas of the renal pelvis and ureter are rare diseases, accounting for only about 1% of all urogenital malignancies. Previous reports suggest that squamous cell histology is associated with inferior survival. We present the largest population based analysis to date of survival in patients with upper urinary tract malignancies. Methods: We analyzed the Surveillance, Epidemiology and End Results database for cancer specific survival rates in patients with renal pelvis and ureteral malignancies who were diagnosed between 1973 and 2003 in the SEER catchment geographic areas. The primary exposure of interest was the underlying histology, squamous cell versus transitional cell differentiation. We performed descriptive statistics, non parametric survival analysis, and cox proportional hazard analysis. Results: We identified 13,213 eligible patients, 7,716 renal pelvis and 5,497 ureteral carcinomas. Among this cohort, 179 patients had squamous cell carcinoma (SCC), 12,395 had transitional cell carcinoma (TCC), including 121 papillary, and 619 had other histologies. Overall, patients with SCC histology fared worse. The median overall survival time was 10 months for SCC and 63 months for TCC. The cox analysis revealed a HR 0.42 (95% CI 0.36–0.47) for TCC when compared to SCC and corrected for decade of diagnosis, age, gender, prior treatment, and race. The difference between the two groups was entirely attributable to survival differences in patients with loco-regional disease. However, when stratified by lymph node involvement this difference disappeared for patients with locally involved lymph nodes (p = 0.84) and for patients with clear lymph nodes (p = 0.92). Conclusions: SCCs of the upper urinary tract present at a higher clinical stage and appear to represent more aggressive disease when compared to other histologies. However, when appropriately staged according to lymph node status, the survival of TCC and SCC of the upper urinary tract is identical when compared stage by stage. No significant financial relationships to disclose.

scholarly journals Survival of Patients with Squamous Cell Malignancies of the Upper Urinary Tract

2011 ◽  
Vol 6 ◽  
pp. CMO.S8103 ◽  
Author(s):  
David Berz ◽  
Tina Rizack ◽  
Sherry Weitzen ◽  
Anthony Mega ◽  
Joseph Renzulli ◽  
...  
Keyword(s):  
Lymph Node ◽  
Urinary Tract ◽  
Lymph Nodes ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Renal Pelvis ◽  
Clinical Stage ◽  
Transitional Cell ◽  
Upper Urinary Tract ◽  
Lymph Node Status

Background Carcinomas of the renal pelvis and ureter are rare diseases, accounting for only about 1% of all urogenital malignancies. Previous reports suggest that squamous cell histology is associated with inferior survival. We present the largest population based analysis to date of survival in patients with upper urinary tract malignancies. Methods We analyzed the Surveillance, Epidemiology and End Results database for cancer specific survival rates in patients with renal pelvis and ureteral malignancies who were diagnosed between 1973 and 2003 in the SEER catchment geographic areas. The primary exposure of interest was the underlying histology, squamous cell versus transitional cell differentiation. We performed descriptive statistics, non parametric survival analysis, and cox proportional hazard analysis. Results We identified 13,213 eligible patients, 7,716 renal pelvis and 5,497 ureteral carcinomas. Among this cohort, 179 patients had squamous cell carcinoma (SCC), 12,395 had transitional cell carcinoma (TCC), including 121 papillary, and 619 had other histologies. Overall, patients with SCC histology fared worse. The median overall survival time was 10 months for SCC and 63 months for TCC. The cox analysis revealed a HR 3.7 (95% CI 3.0–4.5) for SCC when compared to TCC and corrected for decade of diagnosis, age, gender, prior treatment, and race. The difference between the two groups was entirely attributable to survival differences in patients with loco-regional disease. However, when stratified by lymph node involvement this difference disappeared for patients with locally involved lymph nodes ( P = 0.84) and for patients with clear lymph nodes ( P = 0.92). Conclusions SCCs of the upper urinary tract present at a higher clinical stage and appear to represent more aggressive disease when compared to other histologies. However, when appropriately staged according to lymph node status, the survival of TCC and SCC of the upper urinary tract is identical when compared stage by stage.

scholarly journals Ureterocolonic Anastomosis in a Dog with Transitional Cell Carcinoma in the Vesical Trigone

2016 ◽  
Vol 44 (1) ◽  
pp. 5
Author(s):  
Gabriela Friedrich Lobo D'Avila ◽  
Elissandra Da Silveira ◽  
Maria Eduarda Baier ◽  
Aline Silva Gouvêa ◽  
Natália Fagundes ◽  
...  
Keyword(s):  
Serum Creatinine ◽  
Lymph Nodes ◽  
Transitional Cell Carcinoma ◽  
Cell Carcinoma ◽  
Urinary Diversion ◽  
Renal Pelvis ◽  
Ureteral Obstruction ◽  
Transitional Cell ◽  
Elevated Serum ◽  
Ascending Infection

Background: Primary bladder tumors are rare in dogs, in spite of that, the transitional cell carcinoma (TCC) is the malignant tumor that most affects dogs. The TCC usually begins in the vesical trigone and extends into the bladder, and may cause partial or complete obstruction of the urinary flow. The treatment with cystectomy and urinary diversion in veterinary medicine is not usual probably because the partial cystectomy has low success and ureterocolonic anastomosis can cause pyelonephritis and/ or urinary incontinence. This paper describes the cystectomy surgery and ureterocolonic anastomosis in a dog with TCC in the bladder and bilateral hydronephrosis. Case: A 8-year-old, male, not castrated, Pitbull was referred to the Veterinary Clinic Hospital - UFRGS. The patient had progressive weight loss, low appetite, dysuria, and hematuria. Abdominal ultrasound showed bilaterally hydronephrosis, kidney pelvis and ureter dilatation. The mesogastric region presented a mass measuring about 14 cm. An exploratory laparotomy was request by the responsible veterinarian. A mass, measuring about 20 cm was observed in the spleen and a splenectomy was requested. An increased of the kidney’s volume and an expansion of the renal pelvis and ureter were observed. The bladder wall had thickened and presented a firm consistency, an ureterocolonic anastomosis was requested by the responsible veterinarian. Total cystectomy was performed in a second surgical procedure. Six days after the second surgery the patient condition got worse. The dog presented abdominal pain signals and pale mucous membranes. The hematological and biochemistry analysis findings were, severe anemia, and elevated serum creatinine (6.12 mg/dL) and urea (263 mg/dL) levels. Based on severity of clinical signs and unfavorable prognosis the owners elected for euthanasia. Necropsy revealed a viscous material into the left ureter and in left renal pelvis, and papillary necrosis in the right kidney. The histologic assessment revealed tumor cells in regional lymph nodes and lungs. Discussion: The urinary diversion when consist of total cystectomy and ureteral transplantation to the gastrointestinal tract can be considered a therapeutic option in cases where the trigone is affected. In this study an ureterocolonic anastomosis was requested due to bilateral ureteral obstruction caused by TCC involving the trigone. Neurological and gastrointestinal signs, elevated serum creatinine levels and pyelonephritis may occur after surgery. Neurological signs were not observed. The dog, in the present case report, had already azotemia in pre-surgical examinations, probably caused by bilateral ureteral obstruction. One of the reasons for the increase in postoperative serum creatinine levels is chronic renal failure caused by ascending infection or post-renal obstruction. Another reason could also be reabsorption of the metabolite through the colon. Necropsy findings were ascending infection and pyelonephritis. Dilation of ureter at the time of surgery may have predisposed to the ascending infection. In previous studies aggressive surgical therapy did not result in a significant increase in survival time in dogs when compared to chemotherapy. Most dogs presented metastases, observed most frequently in lymph nodes and lungs. In this report the surgery was performed in an attempt to improve kidney function and life quality of the patient during hospitalization. The prognosis was considered unfavorable because of the advanced stage of the disease and kidney failure. The absence of an early diagnosis and inability to start early chemotherapy may result in a reduced in the survival time of these patients. Keywords: vesical neoplasm, hydronephrosis, urinary diversion, dogs.

A case of collecting duct carcinoma (Bellini duct carcinoma) infiltrating diffusely into the entire right kidney

Choonpa Igaku ◽  
2013 ◽  
Vol 40 (2) ◽  
pp. 183-189
Author(s):  
Naoko SHIMAMORI ◽  
Tomonori KISHINO ◽  
Hiroaki OHNISHI ◽  
Mitsuhiro TAMBO ◽  
Yuichi TERADO ◽  
...  
Keyword(s):  
Collecting Duct ◽  
Duct Carcinoma ◽  
Collecting Duct Carcinoma ◽  
Bellini Duct Carcinoma

Endourological treatment of large neoplasm in the lower tract of the ureter

1992 ◽  
Vol 59 (1_suppl) ◽  
pp. 104-107
Author(s):  
V. Gramegna ◽  
S. Capizzi ◽  
D. Spalmero ◽  
A. Madaro ◽  
O. Romano ◽  
...  
Keyword(s):  
Transitional Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Pelvis ◽  
Personal Experience ◽  
Transitional Cell ◽  
Low Grade

Conservative endourological treatment of transitional cell carcinoma of renal pelvis and ureter is controversial. The treatment should be reserved for selected cases and for low grade, low stage, monofocal tumors. Personal experience with endourological treatment of a transitional cell carcinoma of the lower tract of the ureter is presented.

scholarly journals Imaging analysis of 13 rare cases of renal collecting (Bellini) duct carcinoma in northern China: a case series and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhehao Lyu ◽  
Lili Liu ◽  
Huimin Li ◽  
Haibo Wang ◽  
Qi Liu ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Ct Scan ◽  
Clinical Manifestations ◽  
Northern China ◽  
Renal Tumors ◽  
Imaging Features ◽  
Duct Carcinoma ◽  
Pet Ct ◽  
Bellini Duct Carcinoma ◽  
Mass Type

Abstract Background Collecting (Bellini) duct carcinoma (CDC) is a highly malignant and rare kidney tumor. We report our 12-year experience with CDC and the results of a retrospective analysis of patients and tumor characteristics, clinical manifestations, and imaging features by computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET)/CT. Methods Retrospective examination of tumors between January 2007 and December 2019 identified 13 cases of CDC from three medical centers in northern China. All 13 patients underwent CT scan, among which eight underwent dynamic enhanced CT scan, two underwent PET/CT scan, and one underwent magnetic resonance cholangiopancreatography (MRCP) examination. The lesions were divided into nephritis type and mass type according to the morphology of the tumors. Results The study group included ten men and three women with an average age of 64.23 ± 10.74 years. The clinical manifestations were gross hematuria, flank pain, and waist discomfort. The mean tumor size was 8.48 ± 2.48 cm. Of the 13 cases, six (46.2%) were cortical-medullary involved type and seven (53.8%) were cortex–medullary–pelvis involved type. Eleven (84.6%) cases were nephritis type and two (15.4%) were mass type. The lesions appeared solid or complex solid and cystic on CT and MRI. The parenchymal area of the tumors showed isodensity or slightly higher density on unenhanced CT scan in the 13 cases. PET/CT in two cases showed increased radioactivity intake. Evidence of intra-abdominal metastatic disease was present on CT in nine (69.2%) cases. Conclusions The imaging characteristics of CDC differ from those of other renal cell carcinomas. In renal tumors located in the junction zone of the renal cortex and medulla that show unclear borders, slight enhancement, and metastases in the early stage, a diagnosis of CDC needs to be considered. PET/CT provides crucial information for the diagnosis of CDC, as well as for designing treatment strategies including surgery.

Cystic Encapsulated Papillary Carcinoma in the Male Breast: An Unusual Feature With a Diagnostic Challenge

2021 ◽  
pp. 106689692110187
Author(s):  
Rongying Li ◽  
Karan Saluja ◽  
Brenda Mai ◽  
Michael Covinsky ◽  
Hongxia Sun
Keyword(s):  
Papillary Carcinoma ◽  
Cyst Wall ◽  
Correct Diagnosis ◽  
Nipple Discharge ◽  
Left Breast ◽  
Male Breast ◽  
Unusual Feature ◽  
Breast Mass ◽  
Repeat Biopsy ◽  
Bloody Nipple Discharge

Papillary carcinoma in the male breast is uncommon. Here, we report a case of a large encapsulated papillary carcinoma (EPC) in a 62-year-old male. The patient presented with a left breast mass of 1-year duration and bloody nipple discharge for several days. Mammography and breast ultrasonography showed a large left breast mass. The initial biopsy demonstrated fat necrosis with acute and chronic inflammation only. Due to clinical suspicion, a repeat biopsy was performed and revealed scant fragments of papillary carcinoma in a background of inflammation. The patient underwent left total mastectomy. Grossly, the breast contained a 9.0 cm entirely cystic lesion lined by a hemorrhagic thick fibrotic wall. No solid area was identified in the cyst. The entire cyst wall was examined under microscopy; only a few sections with papillary carcinoma were identified. The lesion was confined to the cyst wall; so, a diagnosis of EPC was made. Compared to the previously reported EPC cases of male breast, the lesion of this case was unusually cystic, which making the diagnosis challenging. Therefore, awareness of this unusual feature, repeat biopsy when the pathology result is discordant, and extensive sampling of the lesion are essential for making the correct diagnosis and guiding patient management.

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