Primary renal carcinoid tumour with inferior vena caval tumour thrombus

Abstract

Carcinoid tumours, most frequently reported in the gastrointestinal and respiratory tracts, are exceedingly rare primary renal cancers. Few cases have been published to date. To our knowledge, we report the first case of a primary carcinoid tumour of the kidneys involving the inferior vena cava. We treated a 58-year-old woman with an open radical nephrectomy and cavotomy with thrombectomy. We describe the presentation, investigations and pathology results. We discuss the current experience with carcinoid tumours as a literature review relating to the diagnosis of the disease and the prognosis of patients with this neoplasm. Localized carcinoid tumours of the kidneys, including those involving the vena cava, can be successfully treated with surgical excision. RésuméLes carcinoïdes, principalement observés dans le tractus digestif et les voies respiratoires, sont des tumeurs rénales primitives extrêmement rares. Quelques cas seulement ont été publiés jusqu'à présent. Nous décrivons le premier cas de carcinoïde primitif du rein touchant la veine cave inférieure. Nous avons traité la patiente, âgée de 58 ans, par néphrectomie radicale ouverte et thrombectomie par cavotomie. Nous présentons ici les détails du cas au moment de la consultation, les examens effectués et les résultats des analyses de pathologie. Le niveau actuel d'expéri-ence avec ce type de tumeur est discuté sous forme de revue de la littérature en lien avec le diagnostic et le pronostic. Les carcinoïdes localisés du rein, y compris ceux touchant la veine cave, peuvent être traités avec succès par excision chirurgicale.

Primary Carcinoid Tumour of the Kidney: A Review of the Literature

“…Calcification of varying sizes which may be central or peripheral [10–12, 16, 21–23, 25, 29, 51, 58], foci areas of haemorrhage [15, 30], necrosis and cystic changes has been documented. Although cases with necrosis have been previously reported [69–71] and also observed in our review [8, 15, 17, 26, 28], necrosis has been reported to be unusual [15, 36, 60, 67, 69]. The cystic changes may be uniloculated or multiloculated [34, 43, 53, 72].…”

“…The most commonly reported presenting complaint was abdominal or flank pain [9, 10, 12, 15–17, 19, 21, 22, 26–30]. Other symptoms include haematuria [8, 11, 18, 24] constipation, urinary frequency, fever, epigastric discomfort, weight loss, and abdominal mass [17, 19, 24, 25, 27, 28, 30, 31] which is similar to other research findings [36, 51–53]. …”

“…Primary carcinoid tumour of the kidney thrombus involving the inferior vena cava has been reported [8]. Most cases arise in the renal parenchyma; however, rare cases arising from the renal pelvis have been reported [20, 36, 68, 69].…”

Clinical and Pathological Features of Primary Renal Well-Differentiated Neuroendocrine Tumor

“… 5 Even for patients with inferior vena cava tumor thrombus, radical nephrectomy and removal of the tumor thrombus can ensure long-term survival of the patient. 61 …”