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

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

International Journal of Surgical Pathology ◽

10.1177/10668969211041592 ◽

2021 ◽

pp. 106689692110415

Author(s):

Xunda Luo ◽

Christopher Preciado ◽

Anupma Nayak ◽

Lauren E. Schwartz ◽

Thomas J. Guzzo ◽

...

Keyword(s):

Needle Biopsy ◽

Vascular Invasion ◽

Lymphovascular Invasion ◽

Renal Tumor ◽

Renal Oncocytoma ◽

Review Of The Literature ◽

Renal Oncocytomas ◽

Microscopic Features ◽

Intracytoplasmic Vacuole ◽

Tumor Entities

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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Clinical Implications of (Pro)renin Receptor (PRR) Expression in Renal Tumours

Diagnostics ◽

10.3390/diagnostics11020272 ◽

2021 ◽

Vol 11 (2) ◽

pp. 272

Author(s):

Jon Danel Solano-Iturri ◽

Enrique Echevarría ◽

Miguel Unda ◽

Ana Loizaga-Iriarte ◽

Amparo Pérez-Fernández ◽

...

Keyword(s):

Renal Cell ◽

Tumour Progression ◽

Renin Angiotensin System ◽

Staging System ◽

Staining Intensity ◽

Renal Oncocytoma ◽

Angiotensin System ◽

Promising Therapeutic Target ◽

Renal Tumours ◽

Grade Tumour

(1) Background: Renal cancer is one of the most frequent malignancies in Western countries, with an unpredictable clinical outcome, partly due to its high heterogeneity and the scarcity of reliable biomarkers of tumour progression. (Pro)renin receptor (PRR) is a novel receptor of the renin–angiotensin system (RAS) that has been associated with the development and progression of some solid tumours by RAS-dependent and -independent mechanisms. (2) Methods: In this study, we analysed the immunohistochemical expression of PRR at the centre and border in a series of 83 clear-cell renal cell (CCRCCs), 19 papillary (PRCC) and 7 chromophobe (ChRCC) renal cell carcinomas, and the benign tumour renal oncocytoma (RO, n = 11). (3) Results: PRR is expressed in all the tumour subtypes, with higher mean staining intensity in ChRCCs and ROs. A high expression of PRR at the tumour centre and at the infiltrative front of CCRCC tissues is significantly associated with high grade, tumour diameter, local invasion and stage, and with high mortality risk by UCLA integrated staging system (UISS) scale. (4) Conclusions: These findings indicate that PRR is associated with the development and progression of renal tumours. Its potential as a novel biomarker for RCC diagnosis/prognosis and as a promising therapeutic target should be taken into account in the future.

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Primary Intrapulmonary Thymomas: Case Report and Review of the Literature

Journal of International Medical Research ◽

10.1177/147323000903700434 ◽

2009 ◽

Vol 37 (4) ◽

pp. 1252-1257 ◽

Cited By ~ 8

Author(s):

L Gong ◽

Y-H Li ◽

X-L He ◽

Q Wang ◽

L Yao ◽

...

Keyword(s):

Epithelial Membrane Antigen ◽

Immunohistochemical Analysis ◽

Lung Tumour ◽

Review Of The Literature ◽

Malignant Tumours ◽

Pathological Characteristics ◽

Immunological Phenotype ◽

Type A Thymoma

Primary intrapulmonary thymomas (PIT), which are intrapulmonary tumours without an associated mediastinal component, are very rare; only 29 cases of PIT have been described in the literature since 1951. This report presents a case of PIT in a 59-year old Chinese woman with a type A thymoma (including its pathogenesis, clinical pathological characteristics, immunological phenotype, treatment and prognosis), in the context of a review of the current literature. The origin of thymomas in this unusual location remains unknown. In this case, immunohistochemical analysis demonstrated that the epithelial component was strongly positive for cytokeratin and focally reactive for epithelial membrane antigen. It is concluded that PIT should be considered when the histopathological appearance of a lung tumour is not typical of other pulmonary neoplasms. Complete resection appears sufficient in non-malignant tumours, while in cases of partial resection or malignancy, adjuvant radiotherapy should be considered. Long-term regular clinical follow-up is also warranted, due to the risk of late local recurrence.

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Management of an unusual presentation of foreign body aspiration

The Journal of Laryngology & Otology ◽

10.1017/s0022215100120791 ◽

1992 ◽

Vol 106 (8) ◽

pp. 751-752 ◽

Cited By ~ 11

Author(s):

Hassan H. Ramadan ◽

Nicolas Bu-Saba ◽

Anis Baraka ◽

Salman Mroueh

Keyword(s):

Foreign Body ◽

Subcutaneous Emphysema ◽

Positive Pressure Ventilation ◽

Intermittent Positive Pressure Ventilation ◽

Foreign Body Aspiration ◽

Positive Pressure ◽

Review Of The Literature ◽

X Ray ◽

Post Surgery ◽

Chest X Ray

AbstractForeign body aspiration is a very common problem in children and toddlers and still a serious and sometimes fatal condition. We are reporting on a 2-year-old white asthmatic male who choked on a chick pea and presented with subcutaneous emphysema, and on chest X-ray with an isolated pneumomediastinum but not pneumothorax. On review of the literature an isolated pneumomediastinum without pneumothorax was rarely reported. This presented a challenge in management mainly because of the technique that we had to use in order to undergo bronchoscopy and removal of the foreign body. Apnoeic diffusion oxygenation was used initially while the foreign body was removed piecemeal, and afterwards intermittent positive pressure ventilation was used. The child did very well, and his subcutaneous emphysema and pneumomediastinum remarkably improved immediately post surgery.

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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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Oncocitoma Renale: Una Possibilità per una Terapia Conservativa

Urologia Journal ◽

10.1177/039156039406101s21 ◽

1994 ◽

Vol 61 (1_suppl) ◽

pp. 75-80

Author(s):

L. Benecchi ◽

R. Bordinazzo ◽

G. Catania ◽

O. Privitera

Keyword(s):

Renal Cell Carcinoma ◽

Benign Neoplasm ◽

Solitary Kidney ◽

Conservative Surgery ◽

Renal Oncocytoma ◽

Intercalated Cells ◽

Contralateral Kidney ◽

Renal Tumours ◽

Nephron Sparing ◽

Collecting Tubules

Renal oncocytoma cells differ from those of other renal carcinomas. They arise from the intercalated cells of the collecting tubules. Originally it was considered a benign neoplasm, but it is now believed that it can have a limited but real malignant or metastatic potentiality. Between 1988 and 1992, 53 néphrectomies were performed in our department of urology for renal parenchymal carcinomas. 5 cases were diagnosed as oncocytomas (9.4%). 4 of these occurred in men (80%) and 1 in a woman (20%). The age of the patients is between 45 and 70 years old, with an average age of 60.6 years. At present the therapeutic approach of renal oncocytoma is no different from that of renal cell carcinoma. Standard therapy is radical nephrectomy. In the presence of small and peripheral well-encapsulated renal tumours the techniques of nephron sparing are preferred. In fact, as referred by Steinbach, with conservative surgery, good results were obtained even after 5 years (from 84% to 96%), not only in the imperative indication (tumours found in an anatomically or functionally solitary kidney or bilateral renal tumours) but even in the elective indication (patients with a small solitary mass lesion in the kidney and a normal contralateral kidney).

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A Metachronous, Atypical, Multifocal Renal Oncocytoma with a Concomitant Renal Cell Carcinoma of the Contralateral Side and Bilateral Multifocal Oncocytomas: Two Case Reports and Review of Literature

The Scientific World JOURNAL ◽

10.1100/tsw.2005.73 ◽

2005 ◽

Vol 5 ◽

pp. 545-549 ◽

Cited By ~ 4

Author(s):

Maximilian Burger ◽

Stefan Denzinger ◽

Thomas Filbeck ◽

Arndt Hartmann ◽

Wolfgang Rößler ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Genetic Material ◽

Genetic Alterations ◽

Contralateral Side ◽

Comparative Genomic Hybridisation ◽

Comparative Genomic ◽

Renal Oncocytoma ◽

Chromosome 1P ◽

Renal Tumours ◽

Nephron Sparing

We present one case of a metachronous, atypical, multifocal renal oncocytoma with a concomitant chromophobe renal cell carcinoma (RCC) of the contralateral side and one case of bilateral and multifocal oncocytomas. Oncocytomas are benign renal tumours that rarely appear bilateral or multifocal or with coexisting RCC. A common pathogenic denominator of oncoytomas and RCC is being discussed. The first case was a 63 years old patient presenting with a history of nephrectomy for a pT1 G1 pN0 R0 papillary RCC 4 years prior to presentation, showed two tumours of a singular kidney. Upon nephron-sparing surgery one typical and one atypical oncocytoma with an invasion of the perinephric fat were found. Comparative genomic hybridisation was performed. Both tumours revealed genetic alterations with loss of genetic material on chromosome 1p. The second case was a 62 years old patient presenting with multifocal and bilateral renal tumours of undeclared dignity upon imaging. During open exploration all tumours could be removed by nephron-sparing surgery and were identified as oncocytomas. Again comparative genomic hybridisation was performed. All 4 tumours revealed genetic alterations with loss of genetic material on chromosome 1p, one of the tumours an additional loss of chromosome 10.

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Papillary renal cell carcinoma within a renal oncocytoma: Case report of very rare coexistence

Canadian Urological Association Journal ◽

10.5489/cuaj.1963 ◽

2014 ◽

Vol 8 (11-12) ◽

pp. 928 ◽

Cited By ~ 5

Author(s):

Cevahir Özer ◽

Mehmet Resit Gören ◽

Tulga Egilmez ◽

Nebil Bal

Keyword(s):

Renal Cell Carcinoma ◽

Case Report ◽

Cell Carcinoma ◽

Renal Cell ◽

Radical Nephrectomy ◽

Papillary Renal Cell Carcinoma ◽

Renal Oncocytoma ◽

Renal Neoplasms ◽

Renal Oncocytomas ◽

Papillary Rcc

Renal oncocytomas accounts for 3% to 9% of primary renal neoplasms. The coexistence of renal cell carcinoma (RCC) within the oncocytoma is extremely rare. We report the case of an asymptomatic 74-year-old man with papillary RCC within oncocytoma managed with left radical nephrectomy.

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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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