Renal Oncocytoma With Both Lymphovascular Invasion and Prominent Intracytoplasmic Vacuole-Like Spaces: A Case Report and Review of the Literature

Here we report a case of renal oncocytoma in a 68 year-old male. The diagnosis was initially made on a needle biopsy 6 years prior to the partial nephrectomy. The case is unique that in addition to the gross and microscopic features commonly seen in renal oncocytomas, both lymphovascular invasion and prominent intracytoplasmic vacuole-like spaces are also present in this tumor. Although vascular invasion is increasingly recognized as compatible with renal oncocytoma, intracytoplasmic vacuoles are a rare and unusual finding that may lead to diagnostic difficulty. The diagnosis of renal oncocytoma was confirmed after immunohistochemistry was performed to argue against succinate dehydrogenase deficient renal cell carcinoma (RCC) and chromophobe RCC. This case highlights the importance for practicing pathologists to recognize the rare co-occurrence of lymphovascular invasion and large intracytoplasmic vacuole-like spaces in renal oncocytoma. Other differential diagnoses may include emerging renal tumor entities, such as the recently-proposed eosinophilic vacuolated tumor.

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Bilateral multifocal renal oncocytoma in pregnancy

Rare Tumors ◽

10.4081/rt.2012.e54 ◽

2012 ◽

Vol 4 (4) ◽

pp. 175-177 ◽

Cited By ~ 5

Author(s):

Schalk W. Wentzel ◽

Lodewikus P. Vermeulen

Keyword(s):

Literature Search ◽

Renal Tumor ◽

Elective Caesarean Section ◽

Renal Oncocytoma ◽

Renal Neoplasms ◽

Second Trimester ◽

Renal Masses ◽

Renal Oncocytomas ◽

Recommended Guidelines ◽

In Pregnancy

Renal oncocytomas are the most common benign solid renal tumor, accounting for 3–7% of renal neoplasms. Oncocytomas are multifocal in 2–12% and bilateral in 4–14% of cases. Multifocal bilateral oncocytomas represent only 1.4% of renal cases. We present an extraordinary case of a patient with multifocal bilateral renal oncocytomas during pregnancy. An electronic literature search revealed fewer than 30 reports of on cases of bilateral multifocal renal oncocytomas, none of them occurring in pregnancy. The management of this patient differed from the recommended guidelines for renal masses suspected to be malignant because elective caesarean section and nephrectomy in the second trimester was refused.

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Juxtaglomerular Cell Tumor With Atypical Pathological Features: Report of a Case and Review of Literature

International Journal of Surgical Pathology ◽

10.1177/1066896919868773 ◽

2019 ◽

Vol 28 (1) ◽

pp. 87-91 ◽

Cited By ~ 1

Author(s):

Ashley Hagiya ◽

Ming Zhou ◽

Andrew Hung ◽

Manju Aron

Keyword(s):

Lymphovascular Invasion ◽

Renal Tumor ◽

Clinical Course ◽

Cell Tumor ◽

Pathological Features ◽

Review Of Literature ◽

Review Of The Literature ◽

Juxtaglomerular Cell ◽

Juxtaglomerular Cell Tumor ◽

Mitotic Figures

Juxtaglomerular cell tumor (JGCT) is a rare renal tumor with a predominantly benign clinical course. It affects young adults, who often present with hypertension, hypokalemia, and hyperaldosteronism. The tumor cells are round to spindle-shaped with occasional mild to moderate atypia, but mitotic figures are usually absent. Surgical resection is the treatment of choice. Typically, the blood pressure and renin levels normalize after removal of the tumor. Rare cases of metastatic and recurrent JGCT have been reported including cases with vascular invasion. These cases typically occur in older adults and present with larger tumor size (9-15 cm). We report a case of JGCT, 5.5 cm in greatest dimension, with atypical pathological features including invasion of the renal vein, lymphovascular invasion, and significant pleomorphism with rhabdoid morphology, along with a brief review of the literature.

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Renal Oncocytoma: Report of Two Cases and Review of the Literature

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2020/v32i530412 ◽

2020 ◽

pp. 16-23

Author(s):

E. O. Ofori ◽

B. A. Bin Alhassan ◽

K. Akakpo ◽

E. G. Imbeah ◽

A. Asante-Asamani ◽

...

Keyword(s):

Renal Oncocytoma ◽

Imaging Data ◽

Review Of The Literature ◽

Pathological Characteristics ◽

Post Surgery ◽

Renal Tumours ◽

Renal Oncocytomas ◽

Collecting Ducts ◽

Preoperative Diagnostic ◽

Benign Tumours

Introduction: Renal oncocytomas are benign tumours arising from the intercalated cells of the collecting ducts and account for 3% to 7% of primary renal tumours. It was first described by Zippel in 1942. Oncocytomas are mostly asymptomatic and often discovered incidentally. They are often diagnosed postoperatively due to clinical and radiographic challenges in differentiating them from renal cell carcinoma. Presentation of Case: The present study reports two cases of renal oncocytoma in a 61‑year‑old man who was asymptomatic and a 73‑year‑old woman who was symptomatic. Relevant clinical and imaging data on the two patients were reviewed. Both patients underwent nephrectomy via flank incisions. Discussion: The typical morphologic features of oncocytoma were observed on histological examination of the excised kidney specimens. The postoperative course of each patient was uneventful and they were discharged 14 and 6-days post‑surgery, respectively. In addition, the present study reviews the literature regarding the clinical, radiological and pathological characteristics of renal oncocytoma. Conclusion: Renal oncocytoma though is benign and has an excellent prognosis, the preoperative diagnostic challenges invariable warranted radical nephrectomy.

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Renal oncocytoma with vascular and perinephric fat invasion

Therapeutic Advances in Urology ◽

10.1177/1756287219884857 ◽

2019 ◽

Vol 11 ◽

pp. 175628721988485

Author(s):

Ayo O. Omiyale ◽

James Carton

Keyword(s):

Vascular Invasion ◽

Disease Recurrence ◽

Renal Oncocytoma ◽

Granular Eosinophilic Cytoplasm ◽

Renal Oncocytomas ◽

Eosinophilic Cytoplasm ◽

The Mean ◽

Perinephric Fat ◽

Benign Course

Renal oncocytoma is a benign epithelial neoplasm typically composed of large cells with granular eosinophilic cytoplasm. Although rare, histologically worrisome features such as vascular and perinephric fat invasion have been reported. Of the 159 renal oncocytomas resected at our institution, 20 (12.6%) had vascular and/or perinephric fat invasion. Microscopically, 10 oncocytomas had perinephric fat invasion, 7 had vascular invasion and 3 had both vascular and perinephric fat invasion. Grossly, perinephric fat invasion was visible in three cases and tumour was identified within the branches of the renal vein in two cases. Tumours occurred in 14 men and 6 women (M:F = 2.3:1). The mean age at diagnosis was 64.5 years (range, 33–88 years). A total of 11 cases had radical nephrectomies while 9 cases had partial nephrectomies. There was no evidence of disease recurrence, metastasis or death due to tumour after a mean follow up of 25.6 months (range, 2–103 months). The presence of vascular and perinephric fat invasion in renal oncocytoma though worrisome, does not alter the benign course of the tumour.

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Clinical and Molecular Characteristics and Outcome of Cystic Partially Differentiated Nephroblastoma and Cystic Nephroma: A Narrative Review of the Literature

Cancers ◽

10.3390/cancers13050997 ◽

2021 ◽

Vol 13 (5) ◽

pp. 997

Author(s):

Sophie E. van Peer ◽

Corine J. H. Pleijte ◽

Ronald R. de Krijger ◽

Marjolijn C. J. Jongmans ◽

Roland P. Kuiper ◽

...

Keyword(s):

Prenatal Diagnosis ◽

Genetic Testing ◽

Renal Tumor ◽

Molecular Characteristics ◽

Extensive Literature ◽

Cystic Nephroma ◽

Limited Information ◽

Review Of The Literature ◽

Genetic Characteristics ◽

Excellent Outcome

In children presenting with a predominantly cystic renal tumor, the most likely diagnoses include cystic partially differentiated nephroblastoma (CPDN) and cystic nephroma (CN). Both entities are rare and limited information on the clinical and molecular characteristics, treatment, and outcome is available since large cohort studies are lacking. We performed an extensive literature review, in which we identified 113 CPDN and 167 CN. The median age at presentation for CPDN and CN was 12 months (range: 3 weeks–4 years) and 16 months (prenatal diagnosis–16 years), respectively. No patients presented with metastatic disease. Bilateral disease occurred in both entities. Surgery was the main treatment for both. Two/113 CPDN patients and 26/167 CN patients had previous, concomitant, or subsequent other tumors. Unlike CPDN, CN was strongly associated with somatic (n = 27/29) and germline (n = 12/12) DICER1-mutations. Four CPDN patients and one CN patient relapsed. Death was reported in six/103 patients with CPDN and six/118 CN patients, none directly due to disease. In conclusion, children with CPDN and CN are young, do not present with metastases, and have an excellent outcome. Awareness of concomitant or subsequent tumors and genetic testing is important. International registration of cystic renal tumor cohorts is required to enable a better understanding of clinical and genetic characteristics.

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Malignant Rhabdoid Tumor of the Kidney in an Adult: A Case Report and Review of the Literature

Archives of Pathology & Laboratory Medicine ◽

10.5858/2003-127-e371-mrtotk ◽

2003 ◽

Vol 127 (9) ◽

pp. e371-e373 ◽

Cited By ~ 3

Author(s):

Hong Qi Peng ◽

Albert E. Stanek ◽

Saul Teichberg ◽

Barry Shepard ◽

Ellen Kahn

Keyword(s):

Case Report ◽

Aggressive Behavior ◽

Poor Prognosis ◽

Renal Tumor ◽

Adult Population ◽

Rhabdoid Tumor ◽

Malignant Rhabdoid Tumor ◽

Review Of The Literature ◽

Electron Microscopic ◽

Rhabdoid Tumors

Abstract Malignant rhabdoid tumor of the kidney is an uncommon renal tumor in children. The tumor has aggressive behavior and a poor prognosis and is extremely rare in adults; only 3 cases of renal rhabdoid tumors have been reported in adults. We describe here the microscopic, immunohistochemical, and electron microscopic characteristics of another case in a 38-year-old woman. This case reinforces the importance of recognizing this entity in the adult population.

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Cytologic-Histologic Correlation of Ovarian Aspiration Cytology/Needle Biopsy: A Study of 80 Cases with a Review of the Literature

Journal of the American Society of Cytopathology ◽

10.1016/j.jasc.2012.08.129 ◽

2012 ◽

Vol 1 (1) ◽

pp. S58-S59

Author(s):

Chrisy Mafnas ◽

Ricky Kaneshiro ◽

Mikio Hashiguchi ◽

Pamela Tauchi-Nishi

Keyword(s):

Needle Biopsy ◽

Review Of The Literature ◽

Aspiration Cytology

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Bilateral Renal Tumors in Children: The First 5 Years’ Experience of National Centralization in The Netherlands and a Narrative Review of the Literature

Journal of Clinical Medicine ◽

10.3390/jcm10235558 ◽

2021 ◽

Vol 10 (23) ◽

pp. 5558

Author(s):

Sophie E. van Peer ◽

Janna A. Hol ◽

Alida F. W. van der Steeg ◽

Martine van Grotel ◽

Godelieve A. M. Tytgat ◽

...

Keyword(s):

Renal Tumor ◽

Relevant Literature ◽

Renal Tumors ◽

Chemotherapy Response ◽

Review Of The Literature ◽

Kidney Tumors ◽

Tumor Patients ◽

Nephron Sparing ◽

Expert Center ◽

National Expert

Survival of unilateral Wilms tumors (WTs) is exceeding 90%, whereas bilateral WTs have an inferior outcome. We evaluated all Dutch patients with bilateral kidney tumors, treated in the first five years of national centralization and reviewed relevant literature. We identified 24 patients in our center (2015–2020), 23 patients had WT/nephroblastomatosis and one renal cell carcinoma. Patients were treated according to SIOP-RTSG protocols. Chemotherapy response was observed in 26/34 WTs. Nephroblastomatosis lesions were stable (n = 7) or showed response (n = 18). Nephron-sparing surgery was performed in 11/22 patients undergoing surgery (n = 2 kidneys positive margins). Local stage in 20 patients with ≥1 WT revealed stage I (n = 7), II (n = 4) and III (n = 9). Histology was intermediate risk in 15 patients and high risk in 5. Three patients developed a WT in a treated nephroblastomatosis lesion. Two of 24 patients died following toxicity and renal failure, i.e., respectively dialysis-related invasive fungal infection and septic shock. Genetic predisposition was confirmed in 18/24 patients. Our literature review revealed that knowledge is scarce on bilateral renal tumor patients with metastases and that radiotherapy seems important for local stage III patients. Bilateral renal tumors are a therapeutic challenge. We describe management and outcome in a national expert center and summarized available literature, serving as baseline for further improvement of care.

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Vimentin Reactivity in Renal Oncocytoma: Immunohistochemical Study of 234 Cases

Archives of Pathology & Laboratory Medicine ◽

10.5858/2007-131-1782-vriroi ◽

2007 ◽

Vol 131 (12) ◽

pp. 1782-1788 ◽

Cited By ~ 6

Author(s):

Ondrej Hes ◽

Michal Michal ◽

Naoto Kuroda ◽

Guido Martignoni ◽

Matteo Brunelli ◽

...

Keyword(s):

Differential Diagnosis ◽

Renal Cell ◽

Imaging System ◽

Large Series ◽

Renal Tumors ◽

Renal Oncocytoma ◽

Renal Cell Carcinomas ◽

Central Scar ◽

Renal Oncocytomas ◽

The Difference

Abstract Context.—The expression of vimentin in benign renal oncocytomas has been controversal. However, this is of clinical significance because immunostains may be used in differential diagnosis of renal tumors on limited biopsy specimens. Using different staining and analysis methods, we studied vimentin immunoreactivity in a large series of renal oncocytomas with a special emphasis on the immunoreactivity patterns. Objective.—Immunohistochemical expression of vimentin has been used in the differential diagnosis of renal epithelial neoplasms. Although typically expressed in most renal cell carcinomas, the immunoreactivity of this intermediate filament in renal oncocytomas has been controversial. Design.—We studied vimentin immunoreactivity in a large series of 234 renal oncocytomas using 2 staining methods as well as manual and automated imaging analyses. Results.—We found that the focal vimentin immunoreactivity can be seen in most (72.6%) renal oncocytomas with vimentin-positive tumor cells usually found in the edge of a central scar or in small clusters scattered throughout the tumor. Computer-aided imaging analysis using ChromaVision Automatic Cellular Imaging System II confirmed the difference in vimentin immunoreactivity between oncocytoma and other renal neoplasms. Conclusions.—Our study of vimentin immunohistochemistry in a series of renal oncocytomas, which to our knowledge is the largest ever published, showed focal vimentin positivity detected in most oncocytomas. Because the vimentin staining patterns in renal oncocytomas are different from those seen in clear cell or papillary renal cell carcinomas, we consider vimentin staining to be helpful in the differential diagnosis of oncocytoma from other renal tumor mimics. Furthermore, strong vimentin positivity in a renal cell neoplasm does not exclude the diagnosis of renal oncocytoma, particularly in a limited biopsy specimen.

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