Differences in Organ System of Distant Metastasis by Renal Cell Carcinoma Subtype

Hoffmann, Nathan E.; Gillett, Michael D.; Cheville, John C.; Lohse, Christine M.; Leibovich, Bradley C.; Blute, Michael L.

doi:10.1016/j.juro.2007.09.036

Cited by 80 publications

(49 citation statements)

References 9 publications

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“…Brachyury immunoreactivity in renal cell carcinoma has, to the authors' knowledge, previously been studied in only one series with six cases that were all negative. 6 Particularly, given the rising incidence of metastatic renal cell carcinoma, 14,15 the increasing use of targeted therapies, and the propensity for metastasis to virtually any body site, 16,17 distinction of metastatic clear cell renal cell carcinoma from chordoma is critical. Moreover, the high incidence of bony metastasis in this study (Table 2), an incidence supported by a previous study, 16 makes metastatic clear cell renal cell carcinoma a particularly plausible morphological mimic of chordoma (both axial and extra-axial), particularly on a small biopsy sample.…”

Section: Resultsmentioning

confidence: 99%

Specificity of brachyury in the distinction of chordoma from clear cell renal cell carcinoma and germ cell tumors: a study of 305 cases

et al. 2011

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Brachyury is recognized as a specific marker for notochord-derived tissues and neoplasms, and has become a defining immunohistochemical feature of chordoma. The main differential diagnostic consideration for chordoma is chondrosarcoma, which is known to lack brachyury expression. However, within the spectrum of genitourinary neoplasia, metastatic germ cell tumors and clear cell renal cell carcinoma may also be close morphological mimics of chordoma, particularly given the increasing prevalence of small tissue samples from image-guided biopsies. Although immunoreactivity for brachyury has been reported in a few germ cell tumors, a thorough characterization of staining by specific subtype has not been performed in a large series. Additionally, brachyury expression in clear cell renal cell carcinoma has not been well studied. In this study, immunohistochemical expression with the brachyury antibody was evaluated in 111 germ cell tumors, 30 non-neoplastic and neoplastic (non-germ cell) testicular tissues, and 184 metastatic clear cell renal cell carcinomas using tissue microarray technology. In addition, immunoreactivity for PAX-8 and SALL-4 was evaluated in 12 chordomas on whole section. No nuclear brachyury expression was identified in any of the 101 germ cell tumors within the tissue microarray (including choriocarcinoma (1), embryonal carcinoma (20), intratubular germ cell neoplasia unclassified (2), seminoma (64), spermatocytic seminoma (1), teratoma (5) and yolk sac tumor (8)), in any of the 30 non-neoplastic and neoplastic (non-germ cell) testicular tissues, or in any of the 10 whole-section seminomas. All 184 metastatic clear cell renal cell carcinomas were also non-reactive for brachyury. All 12 chordomas showed strong nuclear immunoreactivity for brachyury, but no expression of SALL-4. In all, 1 of 12 chordoma cases showed patchy, 1 þ nuclear immunoreactivity for PAX-8. This study confirms the specificity of brachyury for chordoma in the differential diagnostic distinction from the potential genitourinary mimics, germ cell tumors and metastatic clear cell renal cell carcinoma. Modern Pathology (2011) 24, 425-429; doi:10.1038/modpathol.2010 published online 19 November 2010 Keywords: brachyury; chordoma; germ cell tumor; metastatic; renal cell carcinoma Brachyury is recognized as a key transcription factor expressed in notochord-derived tissues and neoplasms. Although expression of the novel antigen brachyury has come to be considered a defining diagnostic feature of chordoma, 1-6 few studies have thoroughly addressed specificity of the antibody. Chondrosarcoma, the most recognized differential diagnostic consideration for chordoma, has been thoroughly evaluated in previous studies and does not express brachyury. 2,5-9 However, within the spectrum of genitourinary neoplasia, metastatic germ cell tumors and clear cell renal cell carcinomas may also be close morphological mimics of chordoma, particularly on a small biopsy sample. Immunoreactivity with the brachyury antibody has been reported in a few germ ...

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Section: Resultsmentioning

confidence: 99%

Specificity of brachyury in the distinction of chordoma from clear cell renal cell carcinoma and germ cell tumors: a study of 305 cases

et al. 2011

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“…1 The median time from the nephrectomy to distant metastasis was 1.6 years (range 0 to 25). 11 The most interesting feature in this case is metastatic renal cell carcinoma presenting in the left external auditory canal after four years of completion of treatment of renal cell carcinoma. The patient did not show any evidence of locoregional recurrence at the time of presentation.…”

Section: Discussionmentioning

confidence: 79%

Metastatic renal cell carcinoma in the head and neck region

Gandla

Ramaswamy

Rao

2018

Int J Otorhinolaryngol Head Neck Surg

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<p>We describe 3 rare cases of metastatic renal cell carcinoma in the head and neck region. Our first case was a 72 years old male presented with profuse bleeding from the left ear. On examination, proliferative, pink, friable mass was present in the left external auditory canal. On eliciting the detailed history, it was found that patient had renal cell carcinoma in the left kidney four years back and underwent left radical nephrectomy. Patient underwent left lateral temporal bone resection with cul-de-sac closure. Histopathological examination of the specimen showed metastatic renal cell carcinoma. Our second case was a 64 years old male presented with complaints of growth in the oral cavity of 1 month duration. On examination, 5×3 cms proliferative growth was present in the hard palate. Biopsy from the growth in the hard palate showed metastatic renal cell carcinoma. Patient gave history of renal cell carcinoma in the past for which he did not receive treatment. Our third case was a 45 years old male who presented to us with a diffuse swelling in the left temporal region of 2 months duration. On examination, 3×2 cms swelling was present in the left temporal region. Patient had history of renal cell carcinoma of left kidney and underwent left nephrectomy one year prior to the presentation of the left temporal swelling. Ultrasonography guided biopsy of the left temporal region showed metastatic renal cell carcinoma.</p>

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“…Akciğerde görülen metastatik lezyonların erken evrede tanımlanarak uygun cerrahi veya medikal tedavi ile müdahale edilmesi sağkalım açısından önemlidir (2,4). Çalışmamızda primer tümör boyutuna bakılmaksızın böbrek kitlesi saptanan 215 hasta toraks görüntülemeleri ile akciğer metastazı açısından değerlendirildi.…”

Section: Discussionunclassified

Should We Perform Thoracic Imaging for Every Patient with a Renal Mass?

Şahan¹,

Garayev²,

Akgül³

et al. 2016

uob

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Renal Kitle ile Başvuran Her Hastaya Toraks Görüntülemesi Yapmamız Gerekli mi?Objective: Current guidelines for the management of renal mass recommend thoracic imaging for potential metastatic nodules. Small size of the renal mass can be associated with low metastatic potential, which might question the necessity of thoracic imaging in this patient population. This study sought to evaluate the association of thoracic imaging findings with the renal mass characteristics in patients with pathologically proven renal cell carcinoma (RCC). Materials and Methods:We performed a retrospective analysis of patients with RCC, who underwent radical/partial nephrectomy and had baseline thoracic imaging available for review. Patients with a suspicious pulmonary mass were evaluated by the Department of Thoracic Surgery. Presence of lung nodule(s) and metastasis was determined and compared with patient and renal mass characteristics. Results: A total of 215 patients were included in the study. Pulmonary nodules suspicious for malignancy were present in 26.8% of the cases and 42% of these patients underwent further examination for the presence of a pulmonary mass. Pathological examination of the pulmonary nodule revealed RCC metastasis in 80% of patients who underwent biopsy or excision of the pulmonary nodule. Of note, in the subgroup analysis according to the pathological stage of the renal mass, 19.3% of patients with pT1a disease had a suspicious pulmonary mass on thoracic imaging. Of these patients, 25% underwent further examination of the pulmonary nodule with a RCC metastasis in 66.6%. Conclusion:The presence of suspicious lung nodules in patients with RCC has metastatic potential regardless of the size of the renal mass. These findings underscore the importance of baseline thoracic imaging and vigilant further evaluation of patients in whom pulmonary nodules are identified. Keywords: Renal cell carcinoma, pulmonary metastasis, renal mass, thoracic imaging Amaç: Renal kitle ile başvuran hastalarda akciğerlerin olası metastazlar açısından görüntülenmesi önerilmektedir. Renal kitlelerin küçük boyutlarda saptanmaları düşük metastatik potansiyele sahip olduklarını düşündürebilir ve bu nedenle toraks görüntülemesinin gerekliliği bu hasta grubunda tartışma konusu olabilir. Bu çalışmamızda renal kitle nedeniyle opere edilen ve patolojisi renal hücreli karsinom (RHK) olarak rapor edilen hastalarda, toraks görüntülemesi bulgularının renal kitle özellikleri ile ilişkisini araştırdık. Gereç ve Yöntem: Çalışmamızda kliniğimizde uygulanan radikal/parsiyel nefrektomi ameliyatı patolojisi RHK olarak rapor edilen ve ameliyat öncesi toraks görüntülemesi yapılmış hastalar retrospektif olarak değerlendirildi. Akciğerde şüpheli kitle saptanan hastalar göğüs cerrahisi bölümü tarafından değerlendirildi ve metastaz olduğu düşünülen lezyonlarından örnekleme yapıldı. Renal kitleye ait patolojik incelemede rapor edilen bulgular ile akciğerdeki şüpheli kitle ve metastaz saptanma oranları karşılaştırıldı. Bulgular: RHK tanı alan 215 hastadan %26,8'i...

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Differences in Organ System of Distant Metastasis by Renal Cell Carcinoma Subtype

Abstract: Site of distant metastasis varies significantly by renal cell carcinoma histological subtype. Patients with clear cell renal cell carcinoma are more likely to have metastasis to the lungs while patients with chromophobe renal cell carcinoma are more likely to experience liver metastasis.

Cited by 80 publications

References 9 publications

Specificity of brachyury in the distinction of chordoma from clear cell renal cell carcinoma and germ cell tumors: a study of 305 cases

Specificity of brachyury in the distinction of chordoma from clear cell renal cell carcinoma and germ cell tumors: a study of 305 cases

Metastatic renal cell carcinoma in the head and neck region

Should We Perform Thoracic Imaging for Every Patient with a Renal Mass?

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