Second Primary Renal Cell Carcinoma With Nonrenal Malignancies: An Analysis of 118 Cases and a Review of Literature

ObjectivesTo evaluate the nature, diagnosis, treatment and prognosis of second primary renal cell carcinoma (SPRCC).Materials and MethodsWe retrospectively collected data from 118 patients with SPRCC. Clinical characteristics, imaging features and treatments were analyzed and comparisons between SPRCC and renal metastases (RM) were made.ResultsSPRCC accounts for 11.4% of all RCC. The most common types of extrarenal malignancies included lung, colorectal, breast and gynecological cancers. The median age was 58.5 years old, and 61.0% (72/118) of the patients were male. About 5.1% of the patients presented with symptoms. The average tumor diameter was 4.4 cm (1-8.4 cm). The diagnostic specificity of enhanced computed tomography (CT) was 80.1%. When comparing with RM, more patients with stage I–II extrarenal malignancy and less patients with bilateral, multiple, and endogenic renal masses on computed tomography were found in the SPRCC group. A total of 110 SPRCC patients underwent surgery, including 48 radical nephrectomies and 62 partial nephrectomies. The median overall survival time was 117 months. Female, asymptomatic status, no distant metastasis, and surgical treatment predicted a better survival.ConclusionsSPRCC are not uncommon, and it should be considered during the follow-up of patients with nonrenal malignancy. The differential diagnosis between SPRCC and RM was mainly based on imaging and puncture biopsy.

Download Full-text

A Comprehensive Analysis of Renal Cell Carcinoma as First and Second Primary Cancers

10.21203/rs.3.rs-730176/v2 ◽

2021 ◽

Author(s):

Jinchao Chen ◽

Jianmin Lou ◽

Yedie He ◽

Zhenjie Zhu ◽

Shaoxing Zhu

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Cell ◽

Clinical Symptoms ◽

Second Primary ◽

Renal Surgery ◽

Renal Masses ◽

Prognostic Features ◽

Primary Renal Cell Carcinoma ◽

Significant Difference

Abstract Objective Second primary renal cell carcinoma (2nd RCC) refers to renal cell carcinoma (RCC) diagnosed after another unrelated malignancy. This study aims Tto compare the clinical manifestation, pathology, treatment, and prognostic features of patients with second primary renal cell carcinoma (2nd RCC) and first primary renal cell carcinoma (1st RCC). Materials and Methods Data of the Ppatients with localized RCC were retrospectively collected. They were classified as 2nd RCC or 1st RCC according to a previously diagnosed cancer, including 113 cases of 2nd RCC and 749 cases of 1st RCC. ResultsThe most common types of extrarenal malignancies in patients with 2nd RCC include lung, colorectal, breast, gynecological, and gastric cancers. The age and smoking rate of 2nd RCC patients were significantly higher than in those of 1st RCC patients. For 2nd RCC patients, fFewer 2nd RCC patients had clinical symptoms and a large renal masses tend to be smaller. One hundred and eight (95.6%) patients with 2nd RCC received surgical interventions. All patients with 1st RCC underwent renal surgery. More patients with 2nd RCC underwent a partial nephrectomy. Pathologically, there was no significant difference in postoperative pathological types between the 2nd and 1st RCCs. However, the 2nd RCCs commonly occurred inhad the early stages. The median overall survival (OS) of 2nd RCC patients was 117 months, which was shorter than that of 1st RCC patients. ConclusionsPatients with 2ndSecond RCC are not uncommon. More attention should be paid to screening for 2nd RCC in cancer survivors. There are some differences between patients with 2nd and 1st RCCs that should be viewed separately.

Download Full-text

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.

Download Full-text

Contrast-enhanced computed tomography findings of canine primary renal tumors including renal cell carcinoma, lymphoma, and hemangiosarcoma

PLoS ONE ◽

10.1371/journal.pone.0225211 ◽

2019 ◽

Vol 14 (11) ◽

pp. e0225211

Author(s):

Toshiyuki Tanaka ◽

Hideo Akiyoshi ◽

Hidetaka Nishida ◽

Keiichiro Mie ◽

Lee-Shuan Lin ◽

...

Keyword(s):

Computed Tomography ◽

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Cell ◽

Renal Tumors ◽

Contrast Enhanced ◽

Enhanced Computed Tomography ◽

Contrast Enhanced Computed Tomography

Download Full-text

Oncocytic Papillary Renal Cell Carcinoma in the Background of Renal Adenomatosis

International Journal of Surgical Pathology ◽

10.1177/1066896916663305 ◽

2016 ◽

Vol 25 (1) ◽

pp. 78-82

Author(s):

Ji Yeon Kim

Keyword(s):

Computed Tomography ◽

Renal Cell Carcinoma ◽

Literature Review ◽

Cell Carcinoma ◽

Rare Disease ◽

Renal Cell ◽

Malignant Tumors ◽

Papillary Renal Cell Carcinoma ◽

Renal Masses ◽

Cytological Features

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.

Download Full-text

Differentiation of Clear Cell Renal Cell Carcinoma from other Renal Cell Carcinoma Subtypes and Benign Oncocytoma Using Quantitative MDCT Enhancement Parameters

Medicina ◽

10.3390/medicina56110569 ◽

2020 ◽

Vol 56 (11) ◽

pp. 569

Author(s):

Claudia-Gabriela Moldovanu ◽

Bianca Petresc ◽

Andrei Lebovici ◽

Attila Tamas-Szora ◽

Mihai Suciu ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Cell ◽

Clear Cell ◽

Renal Tumors ◽

3D Analysis ◽

Imaging Features ◽

Enhancement Ratio ◽

Cell Renal Cell Carcinoma ◽

Renal Masses

Background and objectives: The use of non-invasive techniques to predict the histological type of renal masses can avoid a renal mass biopsy, thus being of great clinical interest. The aim of our study was to assess if quantitative multiphasic multidetector computed tomography (MDCT) enhancement patterns of renal masses (malignant and benign) may be useful to enable lesion differentiation by their enhancement characteristics. Materials and Methods: A total of 154 renal tumors were retrospectively analyzed with a four-phase MDCT protocol. We studied attenuation values using the values within the most avidly enhancing portion of the tumor (2D analysis) and within the whole tumor volume (3D analysis). A region of interest (ROI) was also placed in the adjacent uninvolved renal cortex to calculate the relative tumor enhancement ratio. Results: Significant differences were noted in enhancement and de-enhancement (diminution of attenuation measurements between the postcontrast phases) values by histology. The highest areas under the receiver operating characteristic curves (AUCs) of 0.976 (95% CI: 0.924–0.995) and 0.827 (95% CI: 0.752–0.887), respectively, were demonstrated between clear cell renal cell carcinoma (ccRCC) and papillary RCC (pRCC)/oncocytoma. The 3D analysis allowed the differentiation of ccRCC from chromophobe RCC (chrRCC) with a AUC of 0.643 (95% CI: 0.555–0.724). Wash-out values proved useful only for discrimination between ccRCC and oncocytoma (43.34 vs 64.10, p < 0.001). However, the relative tumor enhancement ratio (corticomedullary (CM) and nephrographic phases) proved useful for discrimination between ccRCC, pRCC, and chrRCC, with the values from the CM phase having higher AUCs of 0.973 (95% CI: 0.929–0.993) and 0.799 (95% CI: 0.721–0.864), respectively. Conclusions: Our observations point out that imaging features may contribute to providing prognostic information helpful in the management strategy of renal masses.

Download Full-text