Oncocytic Papillary Renal Cell Carcinoma in the Background of Renal Adenomatosis

Renal adenomatosis is a rare disease characterized by numerous adenomas in bilateral kidneys. A literature review shows that malignant tumors can arise in this condition. The present case describes an oncocytic papillary renal cell carcinoma (PRCC) arising in renal adenomatosis. A 70-year-old man presented with incidentally identified, multiple right renal masses on computed tomography. Right nephrectomy was performed, and the resected kidney revealed numerous radiologically undetected small nodules additionally. Microscopically, the nodules were papillary neoplasms of variable sizes and cytological features. The largest nodule measured 1.6 cm and was composed of oncocytic cells, meeting the diagnostic criteria of oncocytic PRCC. The smaller nodules of papillary adenomas and tiny lesions showing a single papillary ingrowth were also seen. This case exhibits a spectrum of renal papillary neoplasms in a resected kidney and can be a valuable case in the understanding of tumorigenesis.

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Renal Adenomas: Pathological Differential Diagnosis with Malignant Tumors

Advances in Urology ◽

10.1155/2008/974848 ◽

2008 ◽

Vol 2008 ◽

pp. 1-4 ◽

Cited By ~ 11

Author(s):

F. Algaba

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Cell ◽

Malignant Tumors ◽

Papillary Renal Cell Carcinoma ◽

Renal Tumors ◽

Maximum Diameter ◽

Metanephric Adenoma ◽

Cytological Features ◽

Tumors Classification

The renal adenomas can be confused by imaging diagnosis with malignant renal tumors, but there are also real biological dilemmas to determine their behavior. The consensus decisions are the following. (1) The adenoma of clear cells is not accepted, instead it is considered that all the clear-cell tumors are carcinomas, with greater or lesser aggressiveness. (2) Among the papillary neoplasms the WHO 2004 renal cell tumors classification are considered as papillary adenomas tumors with a maximum diameter of 5 mm and may represent a continuum biological process to papillary renal cell carcinoma. The papillary adenomas associated with End-kidney and/or acquired cystic disease may have a different pathogenesis. (3) To consider a tumor as an oncocytoma the size is not important, only the cytological features, microscopic, ultrastructural, and immunohistochemically can help, but some chromosomal observations introduce some questions about its relation with the chromophobe renal cell carcinoma. (4) Finally, the metanephric adenoma, a tumor with some morphological similarity with the nephroblastoma must be considered in the renal adenomas diagnosis.

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Renal collision tumour of papillary cell carcinoma and chromophobe cell carcinoma with sarcomatoid transformation: A case report and review of the literature

Canadian Urological Association Journal ◽

10.5489/cuaj.1811 ◽

2014 ◽

Vol 8 (7-8) ◽

pp. 536 ◽

Cited By ~ 4

Author(s):

Zhang Zhiqiang ◽

Min Jie ◽

Yu Dexin ◽

Shi Haoqiang ◽

Xie Dongdong

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Cell ◽

Histopathological Examination ◽

Papillary Renal Cell Carcinoma ◽

Local Area ◽

Simultaneous Occurrence ◽

Renal Masses ◽

Collision Tumour ◽

Eosinophilic Cytoplasm

The simultaneous occurrence of different histological types of adjacent neoplasms in the same organ is called a collision tumour, and rarely occurs in the kidney. A 63-year-old female presented to the urology department with a 1-month history of a painless hematuria. The computed tomography scans of the abdomen revealed 2 heterogeneous incidental right renal masses. The patient underwent radical nephrectomy including lymphadenectomy without adjuvant therapy. Histopathological examination showed a type 2 renal collision tumour of the papillary renal cell carcinoma with eosinophilic cytoplasm and pseudo stratified nuclei on papillary cores, and chromophobe renal cell carcinoma characterized by large polygonal cells with transparent reticulated cytoplasm and prominent cell membranes, which exhibited sarcomatoid transformation in the local area. Routine follow-up demonstrated no localor distant metastasis signs of recurrence at 20 months.

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Correlation between radiological and histopathological findings in patients undergoing nephrectomy for presumed renal cell carcinoma on computed tomography scan at Grey’s Hospital

South African Journal of Radiology ◽

10.4102/sajr.v22i1.1339 ◽

2018 ◽

Vol 22 (1) ◽

Author(s):

Nompumelelo E. Mlambo ◽

Nondumiso N.M. Dlamini ◽

Ronald J. Urry

Keyword(s):

Computed Tomography ◽

Renal Cell Carcinoma ◽

Ct Scan ◽

Cell Carcinoma ◽

South African ◽

Renal Cell ◽

Vascular Invasion ◽

Retrospective Chart Review ◽

Renal Masses ◽

Cross Sectional

Background: The incidence of renal cell carcinoma (RCC) is increasing globally owing to the increased use of cross-sectional imaging. Computed tomography (CT) scan is the modality of choice in the diagnosis and pre-operative assessment of RCC. Nephrectomy is the standard treatment for RCC and pre-surgery biopsy is not routinely practised. The accuracy of CT diagnosis and staging in a South African population has not been established.Objectives: To determine the accuracy of CT scan in the diagnosis and pre-operative staging of RCC at Grey’s Hospital.Methods: A retrospective chart review was performed; CT scan reports and histopathological results of adult patients who underwent nephrectomy for presumed RCC on CT scan between January 2010 and December 2016 were compared.Results: Fifty patients met the inclusion criteria for the study. CT significantly overestimated the size of renal masses by 0.7 cm (p = 0.045) on average. The positive predictive value of CT for RCC was 81%. Cystic tumours and those 4 cm and smaller were more likely to be benign. CT demonstrated good specificity for extra-renal extension, vascular invasion and lymph node involvement, but poor sensitivity.Conclusion: In our South African study population, CT is accurate at diagnosing RCC, but false-positives do occur. Non-enhancing or poorly enhancing, cystic, fat-containing and small lesions (4 cm or smaller) are more likely to be benign and ultrasound-guided biopsy should be considered to avoid unnecessary surgery. CT assessment of extra-renal extension and vascular invasion is challenging and additional imaging modalities such as magnetic resonance imaging (MRI) venogram, duplex Doppler ultrasound or Positron emission tomography–computed tomography (PET/CT) may be beneficial.

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Papillary renal cell carcinoma with testicular and penile metastases: A case report and literature review

Urology Case Reports ◽

10.1016/j.eucr.2020.101362 ◽

2020 ◽

Vol 33 ◽

pp. 101362

Author(s):

Ferry Safriadi ◽

Bambang S. Noegroho ◽

Bernard Partogu

Keyword(s):

Renal Cell Carcinoma ◽

Case Report ◽

Literature Review ◽

Cell Carcinoma ◽

Renal Cell ◽

Papillary Renal Cell Carcinoma ◽

Penile Metastases

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Incidence of benign versus malignant renal tumors in selected studies.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.5_suppl.357 ◽

2012 ◽

Vol 30 (5_suppl) ◽

pp. 357-357 ◽

Cited By ~ 2

Author(s):

Paul Russo ◽

Robert G. Uzzo ◽

William Thomas Lowrance ◽

Aviva Asnis-Alibozek ◽

Norman David LaFrance ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Cell ◽

Malignant Tumors ◽

Early Stage ◽

Renal Tumors ◽

Benign Tumors ◽

Stage Migration ◽

Renal Masses ◽

Definitive Method

357 Background: Use of cross-sectional imaging has increased the detection rate for small renal tumors; more patients now present with early-stage renal cell carcinoma (RCC) or benign or indolent renal masses. Histopathology after surgical resection is the definitive method for characterizing renal tumors. Stage migration of renal masses creates uncertainty about the percentage of resected masses that will be benign vs malignant. We sought to better define these proportions through a targeted review of the literature. Methods: PubMed/select congresses were searched to identify the histologic classification of renal masses in a representative sample from the contemporary literature: [search] incidence AND (renal cell carcinoma AND benign); incidence AND (renal tumor AND benign); percentage AND (renal cell carcinoma AND benign); limit: 2003–2011. Results: Most representative studies included procedures conducted in the mid-1990s to the mid-to-late 2000s. Studies origin was US (n=8), Korea (n=3), China, Japan, Germany, Austria, Australia, and multisite (Israel/France/US; all n=1). Only 8 studies had n≥500 (range, 70–10,404). The proportion of benign masses are shown (see Table); half of the studies reported values between 16% and 17%. The majority found that benign tumors were more likely to be smaller in size (<4 or <7 cm) than malignant tumors. 11 studies reported the RCC subtype (% clear cell range, 46%–83%). Conclusions: Benign renal tumors occur ~15% of the time and are more prevalent among small masses. Nearly 25% of resected lesions are benign or indolent and may not require surgery. Preoperative discrimination of more aggressive renal masses would be an important clinical advance that could improve clinicians’ diagnostic confidence and guide patient management. Funding: Wilex AG/IBA Molecular. [Table: see text]

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