Temporal Change in Risk of Metachronous Contralateral Renal Cell Carcinoma: Influence of Tumor Characteristics and Demographic Factors

2002 ◽  
Vol 20 (9) ◽  
pp. 2370-2375 ◽  
Author(s):  
Farhang Rabbani ◽  
Harry W. Herr ◽  
Taghreed Almahmeed ◽  
Paul Russo
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Renal Tumor ◽  
Demographic Factors ◽  
White Men ◽  
Initial Diagnosis ◽  
Renal Tumors ◽  
Tumor Characteristics

PURPOSE: To determine the relative risk (RR) of developing a metachronous contralateral renal tumor after an initial diagnosis of renal cell carcinoma (RCC), with stratification by renal tumor characteristics, demographic factors, and follow-up duration, in order to develop an improved risk-based surveillance strategy. PATIENTS AND METHODS: The 1973 to 1997 Surveillance, Epidemiology, and End Results database was used to determine the observed and expected number of metachronous contralateral renal tumors developing after an initial diagnosis of RCC. RESULTS: A total of 43,483 patients had a first diagnosis of RCC. Contralateral RCC developed subsequently in 155 (0.4%) of 40,049 patients with follow-up who had no synchronous diagnosis of RCC, with 10.81 expected cases (RR, 14.3; 95% CI, 12.2 to 16.8). The respective RRs (and 95% CIs) for contralateral RCC for white men and women were 16.0 (11.1 to 22.3) and 13.7 (7.7 to 22.6) at less than 2 years, 8.8 (5.0 to 14.3) and 10.5 (5.0 to 19.3) at 2 to 5 years, 13.5 (8.1 to 21.0) and 5.1 (1.4 to 13.2) at 5 to 10 years, and 13.0 (6.2 to 23.9) and 13.7 (5.0 to 29.9) at ≥ 10 years, respectively. The RRs were significantly higher in black compared with white men for the first 5 years, with the RRs (and 95% CIs) in the former group of 95.3 (58.2 to 146.7) at less than 2 years and 41.9 (16.8 to 86.3) at 2 to 5 years. CONCLUSION: The incidence of metachronous contralateral RCC is stable on long-term follow-up, suggesting that surveillance of the contralateral kidney should remain rigorous on extended follow-up. Black men are at a significantly higher risk of developing contralateral RCC in the first 5 years of follow-up.

scholarly journals Differential Diagnosis of Renal Tumors With Clear Cytoplasm: Clinical Relevance of Renal Tumor Subclassification in the Era of Targeted Therapies and Personalized Medicine

2013 ◽  
Vol 137 (4) ◽  
pp. 467-480 ◽  
Author(s):  
Rajen Goyal ◽  
Elizabeth Gersbach ◽  
Ximing J. Yang ◽  
Stephen M. Rohan
Keyword(s):  
Renal Cell Carcinoma ◽  
Differential Diagnosis ◽  
Cell Carcinoma ◽  
Targeted Therapies ◽  
Renal Cell ◽  
Clear Cell ◽  
Renal Tumor ◽  
Renal Tumors ◽  
Cell Renal Cell Carcinoma ◽  
Immunohistochemical Stains

Context.—The World Health Organization classification of renal tumors synthesizes morphologic, immunohistochemical, and molecular findings to define more than 40 tumor types. Of these, clear cell (conventional) renal cell carcinoma is the most common malignant tumor in adults and—with the exception of some rare tumors—the most deadly. The diagnosis of clear cell renal cell carcinoma on morphologic grounds alone is generally straightforward, but challenging cases are not infrequent. A misdiagnosis of clear cell renal cell carcinoma has clinical consequences, particularly in the current era of targeted therapies. Objective.—To highlight morphologic mimics of clear cell renal cell carcinoma and provide strategies to help differentiate clear cell renal cell carcinoma from other renal tumors and lesions. The role of the pathologist in guiding treatment for renal malignancies will be emphasized to stress the importance of proper tumor classification in patient management. Data Sources.—Published literature and personal experience. Conclusions.—In challenging cases, submission of additional tissue is often an inexpensive and effective way to facilitate a correct diagnosis. If immunohistochemical stains are to be used, it is best to use a panel of markers, as no one marker is specific for a given renal tumor subtype. Selection of limited markers, based on a specific differential diagnosis, can be as useful as a large panel in reaching a definitive diagnosis. For renal tumors, both the presence and absence of immunoreactivity and the pattern of labeling (membranous, cytoplasmic, diffuse, focal) are important when interpreting the results of immunohistochemical stains.

scholarly journals Renal Tumors in Young Adults: Is Preoperative Computer Tomography Imaging Suggestive for the Nature of the Tumors?

Diagnostics ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. 380
Author(s):  
Andreea Zaharie ◽  
Sorana D. Bolboacă ◽  
Tudor Moisoiu ◽  
Dan Burghelea ◽  
Gheorghita Iacob ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Young Adults ◽  
Cell Carcinoma ◽  
Computer Tomography ◽  
Renal Cell ◽  
Clear Cell ◽  
Renal Tumors ◽  
Tomography Imaging ◽  
Computer Tomography Imaging

Renal cell carcinoma (RCC) accounts for 2–3% of all adult malignant neoplasms and is even rarer in patients under 45 years old. Clear-cell carcinoma represents most of the pathological subtypes. Our study aimed to investigate the association between preoperative computer tomography imagistic evaluation and histopathological diagnosis of renal tumors in young adults. Patients younger than 45 years old with renal tumors who were referred for medical treatment at the Clinical Institute of Urology and Renal Transplantation Cluj-Napoca from 2012 to 2019 were considered eligible for the study. Medical charts were retrospectively reviewed, and patients with complete data regarding preoperative diagnostic, histopathological evaluation, and follow-up data, regardless of gender, were included in the study. Sixteen patients younger than 45 years fulfilled all the inclusion criteria and were evaluated. With two exceptions, the evaluated patients were in a T1 and T2 stage, with no vascular invasion or of the adjacent organs. Two-thirds of our patients had a clear-cell renal cell carcinoma. None of our patients fitted in the low complexity surgery category of the R.E.N.A.L. Nephrometry Score and 37.5% of them benefited from partial nephrectomy. Half of the suppositions made based on imaging were concordant with the histopathology report. Fifteen of the patients showed no recurrence during the respective follow-up interval. Computer tomography imaging reports showed on our sample a higher concordance with the histopathological report in the more common subtypes (namely Renal Clear Cell RCC), with typical appearances.

A Composite Renal Tumor: Metanephric Adenofibroma, Wilms Tumor, and Renal Cell Carcinoma: A Missing Link?

2012 ◽  
Vol 15 (1) ◽  
pp. 65-70 ◽  
Author(s):  
Maria Laura Galluzzo ◽  
Maria T. Garcia de Davila ◽  
Gordan M. Vujanić
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Renal Tumor ◽  
Wilms Tumor ◽  
Papillary Renal Cell Carcinoma ◽  
Renal Tumors ◽  
Metanephric Adenoma ◽  
Missing Link ◽  
Additional Support

A coexistence of different renal tumors has rarely been reported. The most commonly described association is of Wilms tumor and renal cell carcinoma. Metanephric adenofibroma has also been associated with Wilms tumor or papillary renal cell carcinoma. Another reported association is metanephric adenoma and papillary renal cell carcinoma with sarcomatoid dedifferentiation. Herein we describe a complex renal tumor containing areas of metanephric adenofibroma, Wilms tumor, and undifferentiated renal cell carcinoma in a previously healthy 18-year-old boy. The tumor showed histologic and immunohistochemical features of these 3 different tumors, offering additional support to the view that these 3 tumors are related.

Multiple Chromophobe and Clear Cell Renal Cancer in A Patient Affected by Birt-Hogg-Dubè Syndrome: A Case Report

2016 ◽  
Vol 84 (2) ◽  
pp. 116-120
Author(s):  
Roberto Castellucci ◽  
Michele Marchioni ◽  
Sergio Valenti ◽  
Giuseppe Sortino ◽  
Giulio Borgonovo ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cancer ◽  
Renal Cell ◽  
Spontaneous Pneumothorax ◽  
Clear Cell ◽  
Renal Tumors ◽  
Kidney Tumors ◽  
Pulmonary Cysts

Objectives Birt-Hogg-Dubé syndrome (BHDS) is a rare autosomal dominant characterized by the presence of fibrofolliculomas and/or trichodiscomas, pulmonary cysts, spontaneous pneumothorax, and renal tumors. The syndrome is linked to mutations in the FLCN gene, which is preferentially expressed in the skin, kidney, and lung. The aim of our paper is to describe a case of multiple bilateral renal cancer in a patient affected by BHDS. Case Presentation Patient subjected to enucleoresection seven kidney tumors discovered right after ultrasound performed for other reasons. Definitive histologic examination were as follows: multifocal type chromophobe renal cell carcinoma and clear cell. After 1 month, the patient was readmitted for spontaneous pneumothorax. After about a year, the patient was again subjected to resection of multiple renal tumors left. Histological examination proved that it was multifocal renal cell carcinoma, clear cell varieties. The genome analysis highlighted positive for mutation c. 1379_1380 of FLCN gene, BHDS gene. Currently, the patient is under close follow-up. After 1 year, the chest computed tomography (CT) confirmed the presence of minute air bubbles scattered on both sides. Instead, the abdominal CT was positive for a small round lesion 6 mm exophytic. Conclusions The BHDS is a rare syndrome whose management is extremely complex both in terms of oncological and functional. Kidney tumors associated with BHDS usually have a favorable clinical course. Present evidence suggests a close follow-up of the carriers of the genetic mutation patients whether or not they have expressed the lesions of disease given the high rate of recurrence of renal lesions.

scholarly journals Tubulocystic Renal Cell Carcinoma: A Rare Renal Tumor

2014 ◽  
Vol 1 (5) ◽  
pp. 56-62 ◽  
Author(s):  
Jasneet Singh Bhullar ◽  
Sandiya Bindroo ◽  
Neha Varshney ◽  
Vijay Mittal
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Renal Tumor ◽  
Renal Tumors ◽  
Extensive Literature ◽  
Vancouver Classification ◽  
Distinct Entity ◽  
Extensive Literature Search

Tubulocystic renal cell carcinoma of the kidney is a rare entity with less than one hundred cases reported so far. It was previously considered to have some similarities to various other renal cancers although this tumor has distinct macroscopic, microscopic and immuno-histochemical features. It is now a well-established entity in renal neoplastic pathology and has been recognized as a distinct entity in the 2012 Vancouver classification of renal tumors. This review aims to give an overview of tubulocystic renal cell carcinoma after extensive literature search using PubMed and CrossRef. 

Proposal for tripartite re-classification of T1 renal cell carcinoma into cT1a (very low risk), cT1b (low risk), and cT1c (intermediate risk) substages.

2019 ◽  
Vol 37 (7_suppl) ◽  
pp. 618-618
Author(s):  
Aaron Bradshaw ◽  
Robert Uzzo ◽  
Alessandro Larcher ◽  
Ahmed Eldefrawy ◽  
Umberto Capitanio ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Tumor Grade ◽  
Tumor Stage ◽  
Low Risk ◽  
Renal Tumors ◽  
Intermediate Risk

618 Background: Criteria for staging of T1 renal tumors into T1a (≤4cm) and T1b (4cm< and ≤7cm) have remained unchanged since 1997. Advancements in tumor biology have noted the heterogeneous potential of T1 renal tumors. We hypothesized that a three-tier classification may more rationally risk stratify T1 renal masses than the current T1a/T1b system. Methods: Multicenter (UCSD, Fox Chase Cancer Center, Ospadele San Raffaele) retrospective analysis of patients with cT1 renal cell carcinoma treated between 1987 and 2018. Patients were stratified into three groups: cT1a (≤2cm, very low risk), cT1b (2cm< and ≤5cm, low risk), and cT1c (5cm< and ≤7cm, intermediate risk). Primary outcome was recurrence free survival (RFS). Secondary outcome was overall survival (OS). Multivariable Cox Regression analysis (MVA) and Kaplan-Meier analyses (KMA) were utilized. Results: 3,324 patients were stratified into proposed T1 groups (T1a=578, T1b=2111, T1c=635; median follow-up 50 months). For cT1a, cT1b and cT1c, KMA revealed 5 year RFS of 96.9%, 91.6%, and 80.6% (p<0.001), and 5 year OS of 91.9%, 86.3%, and 76.2% (p<0.001). MVA for RFS revealed increasing age (HR=1.02, p<0.001), diabetes mellitus (HR=1.36, p=0.04), high tumor grade (HR=2.22, p<0.001) and tumor stage (Referent T1a; cT1b HR=2.18 p=0.001, cT1c HR=5.01 p<0.001) as independent risk factors. MVA for OS revealed increasing age (HR=1.05, p<0.001), diabetes mellitus (HR=1.57, p<0.001), high tumor grade (HR=1.34, p=0.002) and tumor stage (Referent T1a; cT1b HR=1.26 p=0.1, cT1c HR=2.050 p<0.001) as risk factors. Conclusions: Subclassification of cT1 renal cell carcinoma into three clinical stage categories corresponds to distinctive tumor groups whose biological potential varies significantly. Division into three distinct categories may enhance risk stratification, refine preoperative counseling, and augment postoperative follow-up protocols by delineating a very low risk and intermediate risk subset of renal tumors. [Table: see text]

scholarly journals Renal artery aneurysm misdiagnosed as renal cell carcinoma

2020 ◽  
Vol 7 (4) ◽  
pp. 1296
Author(s):  
Shashi . ◽  
Rajdeep Singh ◽  
Manu Vats
Keyword(s):  
Renal Cell Carcinoma ◽  
Renal Artery ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Renal Tumor ◽  
Artery Aneurysm ◽  
Renal Tumors ◽  
Renal Artery Aneurysm ◽  
Suspicious Lesion ◽  
Management Protocol

Renal tumors are best diagnosed by contrast-enhanced computed tomography (CECT) abdomen along with history and physical examination. In case of suspicious lesions in respect to location like lesion arising from the bifurcation of renal artery and close to major vessels with all features suggesting of tumor with absent contrast enhancement and absent color flow on Doppler study should be further investigated keeping other possibility of Renal artery aneurysm with thrombus mimicking as renal tumor. CT angiography should be done in every case of suspicious lesion because this will change the further management protocol from Nephrectomy in case of renal tumor to kidney preserving minimally invasive procedure for renal artery aneurysm. Like in this case diagnosis of Renal cell carcinoma was made on the basis of CECT abdomen findings and managed further as per the management protocol for renal tumor but intraoperatively found renal artery aneurysm. On conclusion every suspicious lesion of kidney should be further investigated for renal artery aneurysm so that kidney preserving procedure could be planned preoperatively.

scholarly journals Surprisingly Late Metastasis of Renal Cell Carcinoma in the Thyroid Gland Detected by Routine Multiparametric Ultrasound

2020 ◽  
pp. 1-4
Author(s):  
Agata Katarzyna Dukaczewska ◽  
A. Delsa ◽  
M. T. Mogl ◽  
M. H. Lerchbaumer ◽  
L. Mantouvalou ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Thyroid Gland ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Thyroid Nodules ◽  
Renal Tumor ◽  
Left Kidney ◽  
The Past ◽  
Late Metastasis

The differential diagnosis of thyroid nodules in patients treated for renal cell carcinoma in the past can be challenging unless they present sonographic features of malignancy. The possibility of metastases to the thyroid gland, even many years after the primary occurrence of the renal tumor, should always be considered. Here, we present the case of a patient diagnosed with metastases of a renal cell carcinoma to the thyroid 22 years after nephrectomy of the left kidney and uneventful follow-up.

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