Bilateral Multi-Focal Sporadic Papillary Renal Cell Carcinoma: A Unique Surgical Challenge

Bilateral multifocal papillary renal cell carcinoma on autopsy: A case report

“…2 Abdominal CECT remains the most preferred imaging modality for evaluating their clinical staging and operability. 4 Delahunt and Eble in 1997 first described type-1 and type-2 subtypes of PRCC based on their cytological features with a relatively dense packing of nuclei with scarce cytoplasm imposes PRCC1 and papillae with pseudolayering cells with abundant, eosinophilic cytoplasm, round nuclei with irregular shape and prominent nucleoli in PRCC2. 11 In a study done by Pan et al on 102 patients of PRCC of which 42 cases were PRCC1 and 60 type II.…”

“…3 PRCC is a slow-growing neoplasm accounting for 5-15% of renal carcinoma and has a relatively favourable prognosis. 4 The mean age of presentation of PRCC ranges from sixth to seventh decade with male predominance. 2 Major etiologic factors associated are lifestyle changes such as smoking, obesity and hypertension, first-degree relative with kidney cancer as well as familial cancer syndromes mainly Von Hippel-Lindau syndrome.…”

“…2 Major etiologic factors associated are lifestyle changes such as smoking, obesity and hypertension, first-degree relative with kidney cancer as well as familial cancer syndromes mainly Von Hippel-Lindau syndrome. 4 Bilateral RCCs are rare accounting for 3-5% in the epidemiology of the disease and greatly challenging for the surgeons to balance between oncological principles vis-à-vis exploiting renal function to circumvent renal replacement therapy. 4 The main pathophysiology behind bilateral RCC is either as a consequence of spread from the primary RCC or a de novo process which remains still unclear regardless of whether the disease is metachronous.…”

“…4 Bilateral RCCs are rare accounting for 3-5% in the epidemiology of the disease and greatly challenging for the surgeons to balance between oncological principles vis-à-vis exploiting renal function to circumvent renal replacement therapy. 4 The main pathophysiology behind bilateral RCC is either as a consequence of spread from the primary RCC or a de novo process which remains still unclear regardless of whether the disease is metachronous. However, a contralateral tumour is considered to be a new primary RCC especially in absence of any evidence of distant disease.…”

“…Majority are incidentally detected on imaging studies performed for other purposes. 4 Metastasis to adrenal glands is most commonly seen however PRCC can also metastasise to other organs such as lungs. 6 Genetically, PRCC is typically associated with gain of chromosome 7 or 17 and loss of chromosome Y.…”