Metachronous Renal Oncocytomatosis

S, A'ch; Chapuis, H; Mottet, Nicholas

doi:10.1159/000068760

Cited by 10 publications

(4 citation statements)

References 8 publications

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“…1,2,8-15 Our group previously published the morphologic features and imaging characteristics of renal oncocytosis. 2,16 However, the prognosis and clinical behavior of these tumors remain unclear.…”

Section: Introductionmentioning

confidence: 99%

Renal Oncocytosis: Management and Clinical Outcomes

et al. 2011

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Purpose Renal oncocytosis is an extremely rare pathological condition in which renal parenchyma is diffusely involved by numerous oncocytic nodules, in addition to showing a spectrum of other oncocytic changes. Our aim was to describe our experience with renal oncocytosis, focusing on management and outcomes. Materials and Methods Twenty patients with a final pathologic diagnosis of renal oncocytosis from July 1995 through June 2009 were included in the analysis. Patient demographics, intraoperative variables and postoperative outcomes are reported. Results The median age at nephrectomy was 71 years. Fifteen patients (75%) had bilateral disease. There were 23 operations performed on 20 patients. Thirteen (57%) were partial nephrectomies and 10 (43%) were radical nephrectomies. The median diameter of the dominant tumor mass was 4.1 cm (range 1–14.6). The most common dominant tumor histology was hybrid tumor between oncocytoma and chromophobe renal cell carcinoma in 13 of 23 specimens (57%), followed by chromophobe RCC in 6 (26%), oncocytoma in 3 (13%) and conventional RCC in 1 (4%). Ten patients (50%) had pre-existing chronic kidney disease before nephrectomy and 5 more developed CKD after surgery. After a median follow-up of 35 months, no patient developed metastatic disease. Conclusions Patients with renal oncocytosis usually present with multiple and bilateral renal nodules. Half of the patients had CKD at diagnosis and 25% developed new-onset of CKD. No patient developed distant metastatic disease during follow-up. Our management approach is to perform a partial nephrectomy when possible and then employ careful surveillance of the remaining renal masses.

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Section: Introductionmentioning

confidence: 99%

Renal Oncocytosis: Management and Clinical Outcomes

et al. 2011

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“…The previously reported cases are summarized in Table 2 2,3,8,11–16 . The ages of the patients ranged between 12 and 76 years old (mean 55.5 years old).…”

Section: Discussionmentioning

confidence: 99%

Renal oncocytosis

Nagashima

Mitsuya

Shioi

et al. 2005

Pathology International

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Renal oncocytosis is a rare disorder in which numerous oncocytic nodules develop in the kidney. An additional case is reported here. The patient was a 51-year-old woman who had received hemodialysis for 27 years. Nineteen years previously she had developed a tumorous lesion in the right kidney, which had been diagnosed as oncocytoma with laparotomic biopsy. Recently the kidney was removed because of enlargement of the tumor. The renal parenchyma was entirely replaced with numerous brownish nodules. Histologically, the nodules were composed of nests of uniform oncocytic cells. Ultrastructurally, the oncocytic cells contained numerous mitochondria. Immunohistochemical features of the nodules were identical to those of sporadic oncocytomas, that is, immunophenotypes similar to the distal nephron and reactivity with antimitochondrial antigen. Based on these findings, the lesion was diagnosed as renal oncocytosis. It was not possible to determine whether the larger nodules should be diagnosed as oncocytoma or a part of oncocytosis. Additionally, the germ line mutation of the Birt-Hogg-Dubé (BHD) syndrome gene was examined using the genomic DNA obtained from the peripheral lymphocytes, which failed to show any gene alteration. Despite the rare occurrence pathologists and urologists should be aware of renal oncocytosis, as a precursor lesion of renal oncocytoma and chromophobe renal cell carcinoma.

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“…Since a coexistence of oncocytomas and RCC evading even advanced imaging techniques cannot be excluded preoperatively [11], techniques such as cryotherapy and radioablation are rejected and a surgical exploration seems warranted [3,5]. A radical excision seems important, as recurrent disease is possible, especially if numerous small foci are present [12]. This feature has been termed oncocytomatosis.…”

Section: Discussionmentioning

confidence: 99%

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

Burger

Denzinger

Filbeck

et al. 2005

The Scientific World JOURNAL

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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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Metachronous Renal Oncocytomatosis

Cited by 10 publications

References 8 publications

Renal Oncocytosis: Management and Clinical Outcomes

Renal Oncocytosis: Management and Clinical Outcomes

Renal oncocytosis

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

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