Metastasizing Renal Cell Carcinoma and Acquired Renal Cystic Disease in a Hemodialysis Patient

Covarsí, A; Rodríguez, Antonio M. Esquinas; Marigliano, N.; Novillo, R

doi:10.1159/000168307

Am J Nephrol

1991

DOI: 10.1159/000168307

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Metastasizing Renal Cell Carcinoma and Acquired Renal Cystic Disease in a Hemodialysis Patient

A Covarsí¹,

Antonio M. Esquinas Rodríguez

N. Marigliano³

et al.

Abstract: Acquired renal cystic disease is an entity which is characterized by the progressive substitution of the atrophic renal parenchyma by multiple cysts in patients with renal insufficiency. Its main complications are hemorrhage and tumorous degeneration. The case discussed is a 57-year-old patient with terminal renal insufficiency secondary to interstitial nephropathy, who, following 6 years of treatment with hemodialysis and renal transplantation, developed a state of persistent hematuria requiring nephrectomy o… Show more

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Cited by 6 publications

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Two cases of urogenital malignancies in male patients undergoing maintenance haemodialysis

Makita

Iwamoto

Sagiyama³

et al. 1994

International Urology and Nephrology

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We report two cases of urogenital malignancies, prostatic cancer in a 72-year-old man and urinary bladder carcinoma in a 50-year-old man, that developed during maintenance haemodialysis. The former patient responded to hormonal therapy with diethylstilboestrol and is still alive on maintenance haemodialysis, but the latter patient did not respond to treatment, being past cure in the far advanced stage. There are few clinical symptoms suggesting the existence of urogenital malignancies in dialysis patients and screening methods such as urine cytology or roentgenology must be restricted because of extremely reduced urine volume. However, the high incidence of urogenital malignancies in such patients is well recognized. Screening examinations with ultrasonography and/or CT scan following digital rectal examination or testing for serum prostate-specific antigen should be performed at least every 6 months.

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Two cases of urogenital malignancies in male patients undergoing maintenance haemodialysis

Makita

Iwamoto

Sagiyama³

et al. 1994

International Urology and Nephrology

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Renal neoplasm in acquired cystic kidney disease

Truong

Krishnan

Cao

et al. 1995

American Journal of Kidney Diseases

135

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Spectrum of Epithelial Neoplasms in End-Stage Renal Disease

Tickoo¹,

DePeralta-Venturina²,

Harik³

et al. 2006

American Journal of Surgical Pathology

407

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Most (up to 71%) of renal cell neoplasms occurring in patients with end-stage renal disease (ESRD), particularly with acquired cystic disease of the kidney (ACDK), have been reported to be papillary renal cell carcinoma (RCC). Our initial experience with tumors in such a setting indicated that many tumors were histologically difficult to classify into the known subtypes of RCC or had features that were different from those in sporadically occurring RCCs. In this study on 66 ESRD kidneys (52 of which showed features of ACDK) removed because tumors were detected in them, we found two major groups of RCC. Overall, there were 261 grossly identified tumors in these kidneys, and many additional tumors were observed on microscopic evaluation in some. Of the two major groups of RCCs, one consisted of tumors similar to those seen in sporadic settings (ie, clear-cell, papillary, and chromophobe RCC), and these formed the dominant mass in 12 (18%), 10 (15%), and 5 (8%) of the 66 kidneys, respectively. The other group consisted of two subtypes of RCC that appear quite unique to ESRD. The more common tumor that we have designated as "acquired cystic disease-associated RCC" was seen as the dominant mass in 24 (36%) of 66 of the kidneys, and it formed the most common tumor type among the smaller nondominant masses, as well. It was characterized by a typical microcystic architecture, eosinophilic cytoplasm with Fuhrman's grade 3 nuclei, and frequent association with intratumoral oxalate crystals. Additionally, these tumors frequently, but usually focally, exhibited papillary architecture, and clear cytoplasm. These tumors occurred only in kidneys with ACDK, and not in noncystic ESRD. The other category was "clear-cell papillary RCC of the end-stage kidneys," present as the dominant mass in 15 (23%) of the 66 kidneys and occurring in both the ACDK and noncystic ESRD. These predominantly cystic tumors showed prominent papillary architecture with purely clear-cell cytology. Immunohistochemical studies in tumors with histology similar to the known subtypes of sporadic RCC showed immunoprofiles similar to that reported in sporadically occurring tumors. The two subtypes of RCC unique to ESRD had distinctive immunoprofiles supporting their separate morphologic subcategorization. Only the acquired cystic disease-associated RCC showed lymph node metastases in 2 cases and sarcomatoid features in 2 more cases. One of the latter 2 died with widespread metastatic disease within 34 months of nephrectomy. Thus, a broad spectrum of renal cell tumors exist in ESRD, only some of which resemble the sporadic RCCs. Acquired cystic disease-associated RCC is the commonest tumor subtype in ESRD, and biologically it appears to be more aggressive than the other tumor subtypes in ESRD.

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Metastasizing Renal Cell Carcinoma and Acquired Renal Cystic Disease in a Hemodialysis Patient

Cited by 6 publications

References 9 publications

Two cases of urogenital malignancies in male patients undergoing maintenance haemodialysis

Two cases of urogenital malignancies in male patients undergoing maintenance haemodialysis

Renal neoplasm in acquired cystic kidney disease

Spectrum of Epithelial Neoplasms in End-Stage Renal Disease

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