scholarly journals Multilocular cystic renal neoplasm-low malignant potential (MCRN-LMP) - review

2020 ◽  
pp. 1-6

Multilocular Cystic Renal Neoplasm of Low Malignant Potential (MCRN-LMP), previously known as multilocular cystic renal cell carcinoma as a rare variant of cystic kidney. It is composed of multiple cysts separated by thin septa covered with clear cells with no expansile growth. The termMCRN-LMPshould be used exclusively to identify a cystic kidney lesion with a small clusters of neoplastic clear cells in the cyst walls. Clinically these cases may present with flank pain or the majority of these tumors are incidentally found on radioimaging. Grossly, the tumor is well demarcated and consists of multiple various-sized cysts. The fibrous septa are generally thin and there is no discernible expansile nodule. The WHO/ISUP nuclear grade is generally low and usually corresponds to grade 1 or 2. In the World Health Organisation (WHO) 2016 classification of kidney tumors recognizes MCRN-LMP as a rare variant of cystic kidney. MCRN-LMP generally exhibits a low stage of TNM classification. These tumors have a favorable clinical course. The clinical course of these lesions suggests that patients may benefit from nephron-sparing surgery. The aim of this review is to bring attention, that MCRN-LPM is a low aggressive neoplasm with no recurrence and no metastatic potential. The updated diagnostic modalities and conservative line of management may be applicable for this rare entity for the better care of patients.

Author(s):  
Mrunal Kesari ◽  
Shweta Agrawal ◽  
Yoganand Patil ◽  
Indranil Bhattacharya ◽  
Monica Dholpure

Multilocular Cystic Renal Neoplasm of Low Malignant Potential (MCRNLMP) represents a rare variant of clear cell (conventional) renal carcinoma. They constitute between 3-6% of clear cell Renal Cell Carcinoma (RCC). The RCC constitutes less than 1% of all renal tumours. The MCRNLMP has an excellent prognosis with no reports of recurrence or metastasis. Authors reported a case of 67-year-old male patient on account of its rarity, co-existing pyelonephritis and incidental detection of MCRNLMP. Differentiation between MCRNLMP, RCC variants and other cystic lesions with clear cells is important as prognosis, treatment differ markedly. Radiological Bosnaik classification of complex cysts in category IIF and III is challenging and requires microscopic examination for correct diagnosis. Histopathology shows cysts separated and fibrous septae having groups of clear cells with low grade nuclei. Immunohistochemistry with Carbonic Anhydrase-IX (CA-IX), Epithelial Membrane Antigen (EMA), Cytokeratin (CK7) and CD10 is confirmatory. Diagnosis requires detailed imaging studies, meticulous grossing of nephrectomy specimens, extensive sampling of cystic tissue to find clear cells and immunohistochemistry (IHC).


Author(s):  
Mandakini M. Patel ◽  
Bhavna N. Gamit ◽  
Sharmishtha I. Patel ◽  
Mubin I. Patel ◽  
Priyanka S. Gandhi

Multi-locular Cystic Renal Cell Carcinoma (MCRCC) is now considered as Multilocular cystic renal neoplasm of low malignant potential (MCRNLMP) in World health organisation classification (WHO) 2016. It is usually seen in elderly people where it can mimic most of the time as benign cystic lesion. Authors are reporting a case of MCRNLMP in a 70 year male diagnosed intraoperative with the help of FNAC. Radiological and other clinical findings are in favour of cystic renal lesion. And it is very important to differentiate it from conventional renal cell carcinoma which requires radical nephrectomy. So, radiological finding and FNAC is instrumental in diagnosing this rare case which require different mode of surgical management. 


2018 ◽  
Vol 16 ◽  
pp. 79-80
Author(s):  
Mrabet Soumaya ◽  
Ksiaa Mehdi ◽  
Mama Nadia ◽  
Yacoubi Tahar ◽  
Elleuch Nour ◽  
...  

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