<p>Clinical Features and Prognostic Outcome of Renal Collecting Duct Carcinoma: 12 Cases from a Single Institution</p>

Abstract

Purpose: Collecting duct carcinoma (CDC) is extremely rare and has high malignancy and poor prognosis. The purpose of this research is to explore the clinical characteristic, imaging, pathological diagnosis, treatment and prognostic outcome of CDCs. Materials and Methods: The clinical data of 12 CDC cases who had been surgically treated between August 2007 and August 2017 and verified the diagnosis of CDC by postoperative pathological and/or immunohistochemical staining (IHC) results were retrospectively analyzed, and related works of literature were reviewed. And Kaplan-Meier survival analysis was used to draw the survival curve and to calculate the survival rate and the median survival time. Results: According to the TNM stage system, 4 cases were in stage I, 2 in stage II,3 in stage III, and 3 in stage IV. On the computed tomograph and magnetic resonance imaging, CDC displayed that various shapes, unclear boundary and invasive growth into the renal parenchyma. Compared with small CDCs which did not change the contour of the kidney, large CDCs presented various imaging features. Microscopically, the typical morphology of CDCs was that collecting ducts or tubules were obviously infiltrated by tumor cells. A tubular, papillary, tubulopapillary or solid architectures with desmoplasia were often presented. And tumor cells had high-grade cytology or an infiltrative growth pattern. Necrosis of tumor cells also was common in many cases. The expression of biomarkers, such as PAX-8, INI-1, 34βE12, CK19, PAX-2, and vimentin, in most patients was detected by IHC. Eleven of all 12 cases received radical surgery, of whom 5 patients died 3-11 months after surgery, and 1 case having undergone interventional embolization therapy died at 6 months after treatment due to multiple metastases. And 1 lost to contact. The overall 1-, 2-, and 5-year survival rates were 45.5%, 36.4%, and 8.8%, respectively, and the median survival time (MST) was 11 months. Conclusion: CDC has an aggressive clinical course, with a poor prognosis. The best way to treat CDC suspected by imaging examinations is radical surgery which can contribute to confirm the correct histopathological type. And post-operation follow-up is necessary.

Incidence, Clinical Characteristics, and Survival of Collecting Duct Carcinoma of the Kidney: A Population-Based Study

“…The clinical symptoms of CDCK vary according to tumor size, location, and invasion. Some patients are diagnosed by physical examination because they have no symptoms ( 15 ), whereas other patients are diagnosed with symptoms at the site of metastasis ( 16 , 17 ). Unfortunately, the absence of information on symptoms in the database prevented us from understanding the characteristics of patients’ symptoms in the present study.…”

A rare case of collecting duct carcinoma with first presentation of respiratory symptoms

“…Histopathological examination of the tissue remains the only precise diagnostic tool; hence percutaneous core biopsy was the option to obtain a confirmed diagnosis directing towards the most appropriate form of treatment in metastatic diseases. 1 , 2 …”

“…CD10 stain was performed to differentiate CCRCC from non-CCRCC which gives a positive membranous pattern of staining. 1 , 5 …”

“…More recent, in the cohort study reported by Qian et al, 12 cases of CDC out of 2200 renal malignancies diagnosed from 2007 to 2017 which is considered the largest number of cases reported in the literature during 10 years showed 11 months median survival rate, and only 1 patient survived for more than 5years even post-surgical treatment by nephrectomy. 1 …”

“…It accounts for less than 1% of all the other types of renal malignant tumors. 1 It is an aggressively behaving tumor with a poor prognosis, most of the few previously reported cases showed a great tendency for metastasis and poor life expectancy, it is considered a rare entity as only few cases were reported in literature. 2 …”