Renal Cell Carcinoma in Young Adults: A Study of 130 Cases and a Review of Previous Series

Abstract

Objective: To characterize a large series of renal cell carcinomas (RCCs) in young patients and to compare the data obtained to previously published data. Patients and Methods: A total of 130 RCCs diagnosed in patients <40 years of age were collected from 9 different hospitals in Spain. Cases were re-evaluated following the diagnostic criteria of the 2004 WHO classification of renal tumors. Results: Histologically, tumors were classified as clear cell (50.7%), papillary (8.5%), chromophobe (14.6%), unclassified (16.9%) and clear cell papillary (9.3%) RCCs. Organ-confined disease (OCD) was detected in 83.6% of the cases. Tumor size and Fuhrman’s grade were statistically correlated (Spearman’s ρ = 0.391). CD10 (p = 0.000), CK7 (p = 0.000), CD15 (p = 0.016), CD117 (p = 0.000), 34βE12 cytokeratin (p = 0.034) and e-cadherin (p = 0.000) immunostaining significantly differentiated the five histological categories. Conclusions: OCD was more common in young RCC patients. The clear cell phenotype accounted for only 50% of RCCs in this age group, with an increasing number of chromophobe and unclassified RCCs. Clear cell RCCs with a papillary growth pattern accounted for a significant proportion of the cases.

Histopathology of surgically treated renal tumours in young adults: a developing country perspective

“…This incidence is markedly less as compared with the Western studies, where incidental detection rates vary between 35 and 75% of all renal tumours (Lopez et al 2010;Taccoen et al 2007;Denzinger et al 2007;Cao et al 2005;Eggener et al 2004;Goetzl et al 2004;Boykin et al 1992;Abou El Fettouh et al 2002;Renshaw et al 1999), but is in keeping with our previous study Wndings (Latif et al 2011). The most probable reason for this appears to be the lack of awareness among the people and the relative inaccessibility of the medical facilities to large sections of the society.…”

“…Right kidney was aVected slightly more often than the left kidney in the present study. The experience of other investigators is more or less similar (Lopez et al 2010;Cao et al 2005;Eggener et al 2004;Goetzl et al 2004;Boykin et al 1992;Abou El Fettouh et al 2002;Renshaw et al 1999). We found bilateral renal tumours in 3% of our young adults, which is comparable to most of the previous studies (Lopez et al 2010;Taccoen et al 2007;Denzinger et al 2007;Cao et al 2005;Eggener et al 2004;Goetzl et al 2004).…”

“…The varying proportions partly reXect the varying deWnitions of young and older adults (Lopez et al 2010;Taccoen et al 2007;Denzinger et al 2007;Cao et al 2005;Eggener et al 2004;Goetzl et al 2004;Boykin et al 1992;Abou El Fettouh et al 2002;Renshaw et al 1999;Rainwater et al 1991;Sanchez-Ortiz et al 2004). The mean age and gender distribution of our study cohort are almost comparable to the published literature on the subject (Lopez et al 2010).…”

“…Recently, some investigators have observed that the spectrum of renal tumours in young adults is markedly diVerent from that seen in older adults, and hence their presenting features, pathological proWle, biological behaviour and clinical outcome are diVerent (Lopez et al 2010;Taccoen et al 2007;Denzinger et al 2007;Cao et al 2005;Eggener et al 2004;Goetzl et al 2004;Boykin et al 1992;Abou El Fettouh et al 2002;Renshaw et al 1999;Rainwater et al 1991;Sanchez-Ortiz et al 2004). We have earlier reported in a preliminary study the spectrum of the renal tumours in an unselected small group of adults from Pakistan (Latif et al 2011).…”

Differential Diagnosis of Renal Tumors With Clear Cytoplasm: Clinical Relevance of Renal Tumor Subclassification in the Era of Targeted Therapies and Personalized Medicine

“…95 Interestingly, these tumors appear to be more common in patients younger than 40 years. 96 All cases of CpRCC reported in the literature have been organ confined and most have been low grade. 71,93,95,[97][98][99] No metastases from CpRCC have been reported to date, suggesting that these tumors may be less aggressive than CCRCC, PRCC, and ChRCC.…”