Microcystic urothelial cell carcinoma with neuroendocrine differentiation arising in renal pelvis. Report of a case

Pacchioni, Donatella; Bosco, Martino; Allìa, Elena; Mussa, Baudolino; Mikuz, Gregor; Bussolati, Gianni

doi:10.1007/s00428-008-0693-7

Cited by 12 publications

(16 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The CK profiling of the present case indicates that CK5/6 emerges and CK20 disappears during sarcomatous transformation in the sarcomatoid carcinoma of the urinary bladder. High-molecular weight CK and CK5/6 are relatively specifically expressed in transitional cell carcinoma [16,17]. In the present case, high-molecular weight CK was present in both elements, though its expression was stronger in sarcomatoid element than in transitional cell carcinoma element.…”

Section: Discussioncontrasting

confidence: 44%

Sarcomatoid carcinoma of the urinary bladder: a case report with immunohistochemical and molecular genetic analysis

Terada

2009

Med Oncol

View full text Add to dashboard Cite

The author reports a rare case of sarcomatoid carcinoma with an emphasis on immunohistochemical features. A 79-year-old man was admitted to our hospital because of hematuria. An endoscopy revealed a large polypoid tumor in the bladder, and urine cytology demonstrated malignant cells. A cystectomy was performed. The patient is now alive without metastasis 4 months after the operation. Grossly, a large polypoid tumor (5 x 6 x 5 cm) was present in the bladder. Microscopically, the tumor consisted of high-grade transitional cell carcinoma element (10% in area) and sarcomatoid element (90% in area). There was a gradual transition between the two. The tumor cells were invaded into peribladder tissue (pT3b). Immunohistochemically, the sarcomatoid element was positive for four types of pancytokeratins, high-molecular weight cytokeratin (CK), CK5/6, CK7, CK18, CK19, epithelial membrane antigen (EMA), vimentin, p53 protein, p63, Ki-67 (labeling = 92%), neuron-specific enolase (NSE), and platelet-derived growth factor receptor-alpha (PDGFRA). It was negative for CK14, CK20, melanosome, carcinoembryonic antigen (CEA), desmin, S100 protein, myoglobin, alpha-smooth muscle antigen (ASMA), CD34, chromogranin, synaptophysin, CD56, CD68, and KIT. The transitional cell carcinoma element showed similar immunoreactivity except for negative CK5/6, positive CK20, and negative vimentin. A molecular genetic analysis of KIT gene (exons 9, 11, 13, and 17) and PDGFRA (exons 12 and 18) gene with the use of PCR-direct sequencing showed no mutations. The present case is the first report of sarcomatoid carcinoma of the urinary bladder demonstrating extensive immunohistochemistry and mutational status of KIT and PDGFRA genes. The sarcomatoid carcinoma in the present case may be derived from sarcomatous differentiation of high-grade transitional cell carcinoma.

show abstract

Section: Discussioncontrasting

confidence: 44%

Sarcomatoid carcinoma of the urinary bladder: a case report with immunohistochemical and molecular genetic analysis

Terada

2009

Med Oncol

View full text Add to dashboard Cite

show abstract

“…Neuroendocrine differentiation was suggested by not only immunohistochemical assay but also neurosecretory granules found in tumor cell cytoplasm by electron microscopy. Rarely, neuroendocrine differentiation is observed in microcystic urothelial cell carcinoma of the renal pelvis 17 . Primary neuroendocrine carcinoma of the kidney may be mimicked by neuroendocrine cancer metastasis as reported in Merkel cell carcinoma metastatic to the kidney 18 .…”

Section: Discussionmentioning

confidence: 99%

Primary neuroendocrine carcinoma of the kidney

Jana¹,

Macák²,

Brzula³

et al. 2013

BIOMED PAP

View full text Add to dashboard Cite

Background. The objective of the study was to report a rare case of primary neuroendocrine carcinoma of the right kidney in a 36 year old male. Methods. The patient was clinically assessed; CT and OctreoScan scintigraphy were performed and levels of 5-HIAA, vanillylmandelic acid and NSE were determined. The tumor and metastases were histologically and immunohistochemically examined. Results. The imaging methods showed a cystic tumor in the lower pole of the right kidney. Macroscopically, the entire tumor was sized 8x8x7 cm. Histologically, it was made up of ribbon-line or trabecular patterns of tumor cells. Occasional adenomatoid and cystic structures were present. The tumor cell nuclei were round or oval, with no irregularities and fine lumpy chromatin. The mitotic count was < 1 /10HPF and the proliferation marker Ki-67 was < 1 % of tumor cells. Immunohistochemically, the tumor cells were positive with antibodies against chromogranin A, synaptophysin, CD56 (focally), cytokeratins AE1-AE3 (focally), vimentin (most cells), glucagon (focally), and pancreatic polypeptide (PP; focally). Antibodies against serotonin, somatostatin, gastrin, vasoactive intestinal polypeptide (VIP) and calcitonin did not react with the tumor. The results of biochemical markers (5-HIAA, vanillylmandelic acid and NSE) did not correlate with development or treatment of the tumor. Conclusions. Primary neuroendocrine carcinoma of the kidney was diagnosed both histologically and immunohistochemically. The patient was clinically investigated using CT and OctreoScan scintigraphy. Within two years from nephrectomy, metastases were found in the right humerus and retrocaval lymph nodes. The metastatic lesions were surgically removed. Currently, the patient's condition is good, with no tumor progression detected.

show abstract

“…Based upon the report of Pacchioni and associates [6] it would be suggested that on rare occasions microcystic variant of urothelial carcinoma may have neuroendocrine differentiation.…”

Section: Literature Reviewmentioning

confidence: 99%

“…Pacchioni and associates [6] reported a case of microcystic urothelial cell carcinoma arising in the renal pelvis and showing focal neuroendocrine differentiation. They reported a 55-year-old man with a history of non-small-cell carcinoma of the lung who presented with abdominal pain and haematuria.…”

Section: Literature Reviewmentioning

confidence: 99%

“…Microscopic examination of the nephrectomy specimen revealed invasive carcinoma with prominent microcystic features, with microcysts lined by low columnar and flat cells. Immunohistochemical analysis confirmed the urothelial histotype (positive for thrombomodulin, p63, and high-molecular-weight cytokeratins) and disclosed focal neuroendocrine differentiation [6]. …”

Section: Literature Reviewmentioning

confidence: 99%

See 1 more Smart Citation

Microcystic Variant of Urothelial Carcinoma

Venyo

2013

Advances in Urology

View full text Add to dashboard Cite

Background. Microcystic variant of urothelial carcinoma is one of the new variants of urothelial carcinoma that was added to the WHO classification in 2004. Aims. To review the literature on microcystic variant of urothelial carcinoma. Methods. Various internet search engines were used to identify reported cases of the tumour. Results. Microscopic features of the tumour include: (i) Conspicuous intracellular and intercellular lumina/microcysts encompassed by malignant urothelial or squamous cells. (ii) The lumina are usually empty; may contain granular eosinophilic debris, mucin, or necrotic cells. (iii) The cysts may be variable in size; round, or oval, up to 2 mm; lined by urothelium which are either flattened cells or low columnar cells however, they do not contain colonic epithelium or goblet cells; are infiltrative; invade the muscularis propria; mimic cystitis cystica and cystitis glandularis; occasionally exhibit neuroendocrine differentiation. (iv) Elongated and irregular branching spaces are usually seen. About 17 cases of the tumour have been reported with only 2 patients who have survived. The tumour tends to be of high-grade and high-stage. There is no consensus opinion on the best option of treatment of the tumour. Conclusions. It would prove difficult at the moment to be dogmatic regarding its prognosis but it is a highly aggressive tumour. New cases of the tumour should be reported in order to document its biological behaviour.

show abstract

Microcystic urothelial cell carcinoma with neuroendocrine differentiation arising in renal pelvis. Report of a case

Cited by 12 publications

References 8 publications

Sarcomatoid carcinoma of the urinary bladder: a case report with immunohistochemical and molecular genetic analysis

Sarcomatoid carcinoma of the urinary bladder: a case report with immunohistochemical and molecular genetic analysis

Primary neuroendocrine carcinoma of the kidney

Microcystic Variant of Urothelial Carcinoma

Contact Info

Product

Resources

About